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The Cochrane Database of Systematic... Sep 2015Symphysis fundal height (SFH) measurement is commonly practiced primarily to detect fetal intrauterine growth restriction (IUGR). Undiagnosed IUGR may lead to fetal... (Review)
Review
BACKGROUND
Symphysis fundal height (SFH) measurement is commonly practiced primarily to detect fetal intrauterine growth restriction (IUGR). Undiagnosed IUGR may lead to fetal death as well as increase perinatal mortality and morbidity.
OBJECTIVES
The objective of this review is to compare SFH measurement with serial ultrasound measurement of fetal parameters or clinical palpation to detect abnormal fetal growth (IUGR and large-for-gestational age), and improving perinatal outcome.
SEARCH METHODS
We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (14 July 2015) and reference lists of retrieved articles.
SELECTION CRITERIA
Randomised controlled trials including quasi-randomised and cluster-randomised trials involving pregnant women with singleton fetuses at 20 weeks' gestation and above comparing tape measurement of SFH with serial ultrasound measurement of fetal parameters or clinical palpation using anatomical landmarks.
DATA COLLECTION AND ANALYSIS
Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy.
MAIN RESULTS
One trial involving 1639 women was included. It compared SFH measurement with clinical abdominal palpation.There was no difference in the two reported primary outcomes of incidence of small-for-gestational age (risk ratio (RR) 1.32; 95% confidence interval (CI) 0.92 to 1.90, low quality evidence) or perinatal death.(RR 1.25, 95% CI 0.38 to 4.07; participants = 1639, low quality evidence). There were no data on the neonatal detection of large-for-gestational age (variously defined by authors). There was no difference in the reported secondary outcomes of neonatal hypoglycaemia, admission to neonatal nursery, admission to the neonatal nursery for IUGR (low quality evidence), induction of labour and caesarean section (very low quality evidence). The trial did not address the other outcomes specified in the 'Summary of findings' table (intrauterine death; neurodevelopmental outcome in childhood). GRADEpro software was used to assess the quality of evidence, downgrading of evidence was based on including a small single study with unclear risk of bias and a wide confidence interval crossing the line of no effect.
AUTHORS' CONCLUSIONS
There is insufficient evidence to determine whether SFH measurement is effective in detecting IUGR. We cannot therefore recommended any change of current practice. Further trials are needed.
Topics: Abdomen; Female; Fetal Growth Retardation; Humans; Palpation; Pregnancy; Pubic Symphysis; Randomized Controlled Trials as Topic; Ultrasonography, Prenatal; Uterus
PubMed: 26346107
DOI: 10.1002/14651858.CD008136.pub3 -
Sensors (Basel, Switzerland) Jun 2023Palpation is a simple but effective method to distinguish tumors from healthy tissues. The development of miniaturized tactile sensors embedded on endoscopic or robotic...
Palpation is a simple but effective method to distinguish tumors from healthy tissues. The development of miniaturized tactile sensors embedded on endoscopic or robotic devices is key to achieving precise palpation diagnosis and subsequent timely treatment. This paper reports on the fabrication and characterization of a novel tactile sensor with mechanical flexibility and optical transparency that can be easily mounted on soft surgical endoscopes and robotics. By utilizing the pneumatic sensing mechanism, the sensor offers a high sensitivity of 1.25 mbar and negligible hysteresis, enabling the detection of phantom tissues with different stiffnesses ranging from 0 to 2.5 MPa. Our configuration, combining pneumatic sensing and hydraulic actuating, also eliminates electrical wiring from the functional elements located at the robot end-effector, thereby enhancing the system safety. The optical transparency path in the sensors together with its mechanical sensing capability open interesting possibilities in the early detection of solid tumor as well as in the development of all-in-one soft surgical robots that can perform visual/mechanical feedback and optical therapy.
Topics: Humans; Robotics; Neoplasms; Endoscopy; Touch; Palpation
PubMed: 37420836
DOI: 10.3390/s23125671 -
Cirugia Y Cirujanos 2023The aim of this study was compare the palpation technique and ultrasound-guidance for femoral artery catheterization in pediatric patients undergoing surgery for... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
The aim of this study was compare the palpation technique and ultrasound-guidance for femoral artery catheterization in pediatric patients undergoing surgery for congenital heart disease.
MATERIALS AND METHODS
This prospective and randomized controlled study included American Society of Anesthesiologists III-IV 40 children who underwent congenital heart surgery. The patients were divided into two groups; ultrasound-guided catheterization group and palpation-guided catheterization group. Demographic and clinical characteristics of the patients, access time, success rate, number of attempts, first-attempt success, number of trials, and failed cannulations were recorded.
RESULTS
The diameter of the femoral artery was significantly shorter, access time and numbers of trials were significantly lower, and first-attempt success rate was significantly higher in the US group. The complication rate was significantly higher in the P group. The number of failed catheterization was higher in the P group. Total cost required for the procedure was significantly lower in the US group.
CONCLUSION
We found that ultrasound-guided arterial catheterization increases the success rate and the number of successful catheterizations, while reducing the overall procedure time, incidence of complications, and cost. Therefore, we believe that the use of ultrasound guidance in arterial catheterization in pediatric cardiac surgery would be a better choice.
Topics: Humans; Child; Femoral Artery; Prospective Studies; Catheterization, Peripheral; Ultrasonography, Interventional; Cardiac Surgical Procedures; Palpation
PubMed: 37844890
DOI: 10.24875/CIRU.23000112 -
British Journal of Anaesthesia Jun 2020Train-of-four twitch monitoring can be performed using palpation of thumb movement, or by the use of a more objective quantitative monitor, such as mechanomyography,... (Comparative Study)
Comparative Study
BACKGROUND
Train-of-four twitch monitoring can be performed using palpation of thumb movement, or by the use of a more objective quantitative monitor, such as mechanomyography, acceleromyography, or electromyography. The relative performance of palpation and quantitative monitoring for determination of the train-of-four ratio has been studied extensively, but the relative performance of palpation and quantitative monitors for counting train-of-four twitch responses has not been completely described.
METHODS
We compared train-of-four counts by palpation to mechanomyography, acceleromyography (Stimpod™), and electromyography (TwitchView Monitor™) in anaesthetised patients using 1691 pairs of measurements obtained from 46 subjects.
RESULTS
There was substantial agreement between palpation and electromyography (kappa = 0.80), mechanomyography (kappa = 0.67), or acceleromyography (kappa = 0.63). Electromyography with TwitchView and mechanomyography most closely resembled palpation, whereas acceleromyography with StimPod often underestimated train-of-four count. With palpation as the comparator, acceleromyography was more likely to measure a lower train-of-four count, with 36% of counts less than palpation, and 3% more than palpation. For mechanomyography, 31% of train-of-four counts were greater than palpation, and 9% were less. For electromyography, 15% of train-of-four counts were greater than palpation, and 12% were less. The agreement between acceleromyography and electromyography was fair (kappa = 0.38). For acceleromyography, 39% of train-of-four counts were less than electromyography, and 5% were more.
CONCLUSIONS
Acceleromyography with the StimPod frequently underestimated train-of-four count in comparison with electromyography with TwitchView.
Topics: Accelerometry; Adult; Aged; Electromyography; Female; Humans; Male; Middle Aged; Myography; Palpation; Reproducibility of Results
PubMed: 32228867
DOI: 10.1016/j.bja.2020.02.022 -
The Journal of Manual & Manipulative... Sep 2020An inter and intra rater reliability (INTERR and INTRAR) study was designed. (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
An inter and intra rater reliability (INTERR and INTRAR) study was designed.
METHODS
71 subjects, with primary hip coxarthrosis, were included and randomly divided in a study group (SG= 36) and a control group (CG= 35) to assess the efficacy of the Fascial Manipulation® (FM®) method. The primary objective was the assessment of INTERR and INTRAR about movement verification (MV) and palpation verification (PV) of FM® performed by two physiotherapists (PtA and PtB). The secondary objective was evaluate the efficacy of FM® through MV, PV and pain score. Pain was assessed using the Numeric Rating Scale (NRS). SG received three weekly sessions of FM® byPtA. PtB re-evaluated all the subjects at the end of the study.
RESULTS
Results of the INTERR analysis showed for SG: MV (ICC= 0.92, k= 72.7%); PV (ICC= 0.91, k= 75.7%). For CG : MV (ICC= 0.95, k= 84.2%); PV (ICC= 0.90, k= 75%). Results of the INTRAR analysis for SG reported: MV (ICC= 0.82, k= 74,8%); PV (ICC= 0.60, k= 46.8%); for CG: MV (ICC= 0.93, k= 78.7%); PV (ICC= 0.84, k= 53.3%). Statistical significance were reported in NRS (p = 0.001), MV (p = 0.0003) and PV (p < 0.0001) with better results for SG using "Intention To Treat" method.
DISCUSSION
This study demonstrates that FM® assessment procedures have a high reliability even if applied by practitioners with basic experience. Furthermore FM® treatment can improve pain and ROM in individuals with primary coxarthrosis.
Topics: Fascia; Humans; Movement; Osteoarthritis, Hip; Palpation; Reproducibility of Results
PubMed: 31668142
DOI: 10.1080/10669817.2019.1683675 -
BMC Medical Education Jan 2022Medical school faculty are hard pressed to provide clerkship students with sufficient opportunity to develop and practice their capacity to perform a competent clinical...
BACKGROUND
Medical school faculty are hard pressed to provide clerkship students with sufficient opportunity to develop and practice their capacity to perform a competent clinical examination, including the palpatory examination of the abdomen. We evaluated the impact of training with an abdominal simulator, AbSim, designed to monitor the depth, location, and thoroughness of their palpation and to provide concurrent and summative feedback regarding their performance.
METHODS
All third-year medical students were given the opportunity to develop their palpatory skills with the AbSim simulator during the family medicine rotation. The performance of those who studied with the simulator was measured by its sensors, before and after a training session that included visual feedback regarding the depth and coverage of the student's manual pressure. Additionally, all students reported their confidence in their evolving abdominal palpation skills at the beginning and end of the rotation.
RESULTS
119 (86.9%) of 137 students filled out the initial questionnaire, and 73 (61.3%) studied with the abdominal simulator. The training produced a highly significant improvement in their overall performance (4 measures, p's < 0.001). Pre-training performance (depth calibration and thoroughness of coverage) was not related to the number of months of previous clinical rotations nor to previous internal medicine or surgery rotations. There was little relation between students' confidence in their abdominal examination skills and objective measures of their palpatory performance; however, students who chose the training started with less confidence, and became more confident after training.
CONCLUSIONS
Guided abdominal simulator practice increased medical students' capacity to perform an abdominal examination with more appropriate depth and thoroughness of palpation. Interpretation of changes in confidence are uncertain, because confidence was unrelated to objectively measured performance. However, students with low initial confidence in their abdominal examination seemed to be more likely to choose to study with the abdominal simulator.
Topics: Abdomen; Clinical Competence; Humans; Palpation; Physical Examination; Students, Medical
PubMed: 35081956
DOI: 10.1186/s12909-022-03126-y -
Alternatives To Laboratory Animals :... May 2022In the context of veterinary education, simulators are devices or sets of conditions aiming to imitate real patients and enable students to practice skills without the... (Review)
Review
In the context of veterinary education, simulators are devices or sets of conditions aiming to imitate real patients and enable students to practice skills without the need for live animal use. Simulator use in veterinary education has increased significantly in recent years, allowing consistent practical teaching without reliance on clinical cases. This review examines the available literature regarding the use of simulation and simulators for teaching practical day one competences to veterinary students. Scientific databases were searched and 73 relevant articles were reviewed. The reviewed articles revealed that there are a number of simulators currently available to veterinary educators, that simulators can enhance student skills and provide an alternative learning environment without the need for live animal and/or cadaver use, and that they usually receive positive feedback from the students who use them. There appears to be a bias towards small animal simulators - however, some skills that are developed through the use of small animal or table-top models will be transferrable to other species. The majority of large animal simulators focus on bovine rectal palpation and/or pregnancy diagnosis. Further research is required to increase the repertoire of available simulators for use in veterinary education, in order to improve the practical skills of veterinary students and reduce the use of live animals and cadaver material for teaching purposes.
Topics: Animals; Cadaver; Cattle; Clinical Competence; Digital Rectal Examination; Education, Veterinary; Female; Humans; Pregnancy; Students; Teaching
PubMed: 35587390
DOI: 10.1177/02611929221098138 -
CoDAS 2021To identify muscle tension dysphonia (MTD) signs and symptoms, as well as to analyze the results of vocal parameters, the physical clinical examination of muscle...
PURPOSE
To identify muscle tension dysphonia (MTD) signs and symptoms, as well as to analyze the results of vocal parameters, the physical clinical examination of muscle palpation, the self-perception of vocal symptoms, vocal pain, and fatigue of women with MTD and compare them with women with healthy voices.
METHODS
a cross-sectional study with 45 women (23 with MTD and 22 controls), similar median age between groups. The speech-language and otorhinolaryngological evaluation determined the diagnosis of MTD. All participants responded to the Voice Symptoms Scale (VoiSS), Vocal Fatigue Index (VFI), and Nordic Musculoskeletal Questionnaire (NMQ) protocols. They were also assessed by a palpatory evaluation of the perilaryngeal musculature, auditory-perceptual evaluation, and acoustic analysis of the voice fundamental frequency. The speech sample included sustained vowels "a", "i" and "e" and connected speech, recorded in a silent environment, and submitted to auditory-perceptual evaluation by three judges. In the acoustic analysis, the fundamental frequency and maximum phonation times were extracted.
RESULTS
The MTD group had worse results in VoiSS, VFI, and NMQ, in addition to greater resistance to palpation and a high vertical position of the larynx. The vocal parameters also showed greater deviation in the MTD group, except for the fundamental frequency. There was no relationship between vocal symptoms, fatigue, or pain with the general degree of dysphonia in the MTD group, indicating important symptoms in mild or moderate vocal deviations.
CONCLUSION
women with MTD presented vocal symptoms, vocal fatigue, muscle pain, resistance to palpation and deviated vocal parameters when compared to vocally healthy women.
Topics: Cross-Sectional Studies; Dysphonia; Female; Humans; Muscle Tonus; Muscles; Pain; Palpation; Self Concept; Voice Quality
PubMed: 34346948
DOI: 10.1590/2317-1782/20202020035 -
Clinical Medicine & Research Dec 2018Abdominal palpation is a difficult skill to master in the physical examination. It is through the tactile sensation of touch that abdominal tenderness is detected and...
BACKGROUND
Abdominal palpation is a difficult skill to master in the physical examination. It is through the tactile sensation of touch that abdominal tenderness is detected and expressed through pain. Its findings can be used to detect peritonitis and other acute and subtle abnormalities of the abdomen. Some techniques, recognized as signs or medical eponyms, assist clinicians in detecting disease and differentiating other conditions based on location and response to palpation. Described in this paper are medical eponyms associated with abdominal palpation from the period 1876 to 1907.
DATA SOURCES
PubMed, Medline, on-line Internet word searches, textbooks and references from other source text were used as the data source. PubMed was searched using the Medical Subject Heading (MeSH) of the name of the eponyms and text words associated with the sign.
CONCLUSION
We present brief historical background information about the physician who reported the sign, original description of the sign, and its clinical application and implication in today's medical practice.
Topics: Abdomen; Eponyms; History, 19th Century; History, 20th Century; Humans; Palpation
PubMed: 30166497
DOI: 10.3121/cmr.2018.1423 -
Revista Da Associacao Medica Brasileira... Oct 2016Digital palpation and manometry are methods that can provide information regarding maximum voluntary contraction (MVC) and endurance of the pelvic floor muscles (PFM),... (Observational Study)
Observational Study
INTRODUCTION:
Digital palpation and manometry are methods that can provide information regarding maximum voluntary contraction (MVC) and endurance of the pelvic floor muscles (PFM), and a strong correlation between these variables can be expected.
OBJECTIVE:
To investigate the correlation between MVC and endurance, measured by digital palpation and manometry.
METHOD:
Forty-two women, with mean age of 58.1 years (±10.2), and predominant symptoms of stress urinary incontinence (SUI), were included. Examination was firstly conducted by digital palpation and subsequently using a Peritron manometer. MVC was measured using a 0-5 score, based on the Oxford Grading Scale. Endurance was assessed based on the PERFECT scheme.
RESULTS:
We found a significant positive correlation between the MVC measured by digital palpation and the peak manometric pressure (r=0.579, p<0.001), and between the measurements of the endurance by Peritron manometer and the PERFECT assessment scheme (r=0.559, P<0.001).
CONCLUSION:
Our results revealed a positive and significant correlation between the capacity and maintenance of PFM contraction using digital and manometer evaluations in women with predominant symptoms of SUI.
Topics: Aged; Female; Humans; Manometry; Middle Aged; Muscle Contraction; Palpation; Pelvic Floor; Physical Endurance; Pressure; Reference Values; Urinary Incontinence, Stress; Vagina
PubMed: 27925042
DOI: 10.1590/1806-9282.62.07.635