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American Family Physician Aug 2009Numerous conditions can cause hoarseness, ranging from simple inflammatory processes to more serious systemic, neurologic, or cancerous conditions involving the larynx.... (Review)
Review
Numerous conditions can cause hoarseness, ranging from simple inflammatory processes to more serious systemic, neurologic, or cancerous conditions involving the larynx. Evaluation of a patient with hoarseness includes a careful history, physical examination, and in many cases, laryngoscopy. Any patient with hoarseness lasting longer than two weeks in the absence of an apparent benign cause requires a thorough evaluation of the larynx by direct or indirect laryngoscopy. The management of hoarseness includes identification and treatment of any underlying conditions, vocal hygiene, voice therapy, and specific treatment of vocal cord lesions. Vocal hygiene education is an integral aspect of the treatment of hoarseness in most cases. Referral to a speech-language pathologist for voice therapy may be particularly helpful for patients whose occupation depends on singing or talking loudly or for prolonged periods. Voice therapy is an effective method for improving voice quality and vocal performance in patients with nonorganic dysphonia and for treating many benign pathologic vocal cord lesions. Referral for surgical or other targeted interventions is indicated when conservative management of vocal cord pathology is unsuccessful, when dysplasia or carcinoma is suspected, or when significant airway obstruction is present.
Topics: Adult; Hoarseness; Humans; Laryngitis; Laryngoscopy; Physical Examination; Vocal Cord Paralysis; Voice Quality
PubMed: 19678604
DOI: No ID Found -
Archives of Gynecology and Obstetrics Apr 2021The rapid technical development and portability of ultrasound systems over recent years has had a profound impact on the area of point-of-care-ultrasound (POCUS), both... (Review)
Review
BACKGROUND
The rapid technical development and portability of ultrasound systems over recent years has had a profound impact on the area of point-of-care-ultrasound (POCUS), both in general medicine and in obstetrics and gynecology. The use of POCUS enables the clinician to perform the ultrasound scan either at the medical office or the patient's bedside and used as an extension of the physical examination. Real-time images can immediately be correlated with the patient's symptoms, and any changes in a (critical) patient's condition can be more rapidly detected.
POCUS IN OBGYN
POCUS is also suitable for time-critical scenarios, and depending on the situation and its dynamics, the course and results of any therapy may be observed in real time. POCUS should be considered to be a routine extension of practice for most OB/GYN clinicians as it can give immediate answers to what could be life-threatening situations for the mother and/or baby. With its proven usefulness, the applications and use of POCUS should be incorporated in teaching programs for medical students, OBGYN residents and emergency physicians.
Topics: Gynecology; Humans; Obstetrics; Physical Examination; Point-of-Care Systems; Ultrasonography
PubMed: 33558990
DOI: 10.1007/s00404-021-05972-5 -
International Journal of Environmental... Apr 2022The literature has long highlighted the benefits of sport, but too much sport could indicate a dependence without a substance, namely exercise dependence. The literature...
The literature has long highlighted the benefits of sport, but too much sport could indicate a dependence without a substance, namely exercise dependence. The literature has only recently investigated this issue and therefore several questions are open, particularly with regard to psychopathological significance and gender differences. The aim of this paper is to investigate whether young subjects (M = 20 years) with a risk of exercise dependency and non-dependent symptomatic display other behavioural and psychological suffering and discomforts, or whether such an investment in physical activity is compatible with a framework of relative well-being; and if there are differences related to gender. A total of 396 subjects were involved in this study. Exercise Dependence Scale, Toronto Alexithymia Scale, Subjective Happiness Scale, Satisfaction with Life Scale and an ad hoc questionnaire with information relating to the consumption of alcohol, soft and hard drugs, quality of sleep and nutrition, affective and friendship relationships, hobbies, presence of psychological or physical disorders, motivations for sporting activity, and any traumatic experiences were used. With regard to the Exercise Dependence Scale (EDS), the prevalence of subjects at risk of exercise dependence was 1.5% and that of non-dependents symptomatic was 31.3%. Considering only men, the percentage of subjects at risk of exercise dependence rose to 3% and that of non-dependents symptomatic to 47.9%. Our data support the hypothesis that the risk of exercise dependence and the symptomatic condition without dependence can occur in situations of relative well-being (happiness, satisfaction, relationships) without significant associations with other problematic behaviours. Modest consumption of soft drugs is reported in non-dependent symptomatic subjects. The hypothesis of increased levels of alexithymia is confirmed but limited to the male gender. Gender differences are confirmed in the frequency and motivation to practice sport and in the risk of dependence. It is important that the assessment of addiction risk is integrated with the assessment of alexithymia and personal and social resources over time.
Topics: Affective Symptoms; Exercise; Humans; Male; Sex Factors; Sports; Surveys and Questionnaires
PubMed: 35564683
DOI: 10.3390/ijerph19095288 -
Genes Aug 2023The analysis of genetic material may be the only way to identify an unknown person or solve a criminal case. Often, the conditions in which the genetic material was... (Review)
Review
The analysis of genetic material may be the only way to identify an unknown person or solve a criminal case. Often, the conditions in which the genetic material was found determine the choice of the analytical method. Hence, it is extremely important to understand the influence of various factors, both external and internal, on genetic material. The review presents information on DNA and RNA persistence, depending on the chemical and physical factors affecting the genetic material integrity. One of the factors taken into account is the time elapsing to genetic material recovery. Temperature can both preserve the genetic material or lead to its rapid degradation. Radiation, aquatic environments, and various types of chemical and physical factors also affect the genetic material quality. The substances used during the forensic process, i.e., for biological trace visualization or maceration, are also discussed. Proper analysis of genetic material degradation can help determine the post-mortem interval (PMI) or time since deposition (TsD), which may play a key role in criminal cases.
Topics: Humans; Nucleic Acids; Forensic Genetics; RNA; Autopsy; Physical Examination
PubMed: 37628694
DOI: 10.3390/genes14081643 -
Australian Family Physician Aug 2010Injury to the ulnar collateral ligament (UCL) of the first metacarpophalangeal joint (MCPJ) is a common injury, especially in skiers. It is often misdiagnosed, which can... (Review)
Review
BACKGROUND
Injury to the ulnar collateral ligament (UCL) of the first metacarpophalangeal joint (MCPJ) is a common injury, especially in skiers. It is often misdiagnosed, which can lead to chronic instability.
OBJECTIVE
This article reviews the current literature on UCL injury of the thumb and describes the clinical assessment and management.
DISCUSSION
The UCL of the thumb is often injured as a result of forced abduction of the thumb, with or without extension. The injury can be identified by pain, swelling and haematoma along the ulnar border of the first MCPJ as well as pain and laxity on valgus stress testing. Proper examination involves placing a valgus stress on the thumb and measuring instability. Initial investigation should involve a plain X-ray, supplemented by ultrasound or magnetic resonance imaging, where appropriate. Treatment can be conservative or involve surgical management depending on the severity of the injury.
Topics: Collateral Ligaments; Diagnostic Imaging; Hand Injuries; Humans; Metacarpophalangeal Joint; Physical Examination; Physical Therapy Modalities; Radiography; Skiing; Splints; Thumb; Ultrasonography
PubMed: 20877752
DOI: No ID Found -
Advances in Surgery 2013Our attempts to systematically improve accuracy in the evaluation of patients with suspected appendicitis are, in some ways, hindered by the fact that the condition is... (Review)
Review
Our attempts to systematically improve accuracy in the evaluation of patients with suspected appendicitis are, in some ways, hindered by the fact that the condition is so frequently straightforward to diagnose. Careful history-taking and physical examination are reliable in most patients. However, establishing the diagnosis with these skills alone remains vulnerable to conditions that masquerade as acute appendicitis. A substantial body of clinical research over the last quarter-century has shown that improved accuracy is possible. Strategies for improvement include the use of diagnostic scoring systems, laboratory makers such as CRP, diagnostic laparoscopy, and advanced imaging modalities such as CT, MRI, and US. How clinicians use these strategies depends on many factors related to practice setting, the population served, and clinical goals. In children, for instance, the desire to limit exposure to ionizing radiation competes with the greater anatomic detail that a CT scan can provide; at the same time, many hospitals that treat children do not have the resources to maintain the sort of full-time, highly sophisticated abdominal US programs that achieve the highest rates of diagnostic accuracy in clinical studies. Trade-offs have to be made, but improvement is possible in almost all groups of patients: the clinical community should no longer settle for a 15% NA rate when 5% is clearly possible without adverse consequences. Many clinicians will be faced with the task of evaluating patients suspected of having acute appendicitis. A deliberate, proactive, and, ideally, benchmarked strategy for improving diagnosis should be the standard to which we hold ourselves and the promise we deliver to our patients.
Topics: Acute Disease; Appendectomy; Appendicitis; Diagnosis, Differential; Diagnostic Imaging; Humans; Laparoscopy; Physical Examination; Reproducibility of Results
PubMed: 24298858
DOI: 10.1016/j.yasu.2013.03.003 -
Indian Journal of Ophthalmology Dec 2022As perimetry is a psychophysical test, the thresholds obtained are not only dependent on the functional architecture of the visual system but also on a variety of...
BACKGROUND
As perimetry is a psychophysical test, the thresholds obtained are not only dependent on the functional architecture of the visual system but also on a variety of physical and cognitive factors. Factors such as, Lens rim artifact, improper refraction, miosed pupil and blepharoptosis, can affect luminance thresholds. Additionally, cognitive factors such as patient's attention, motivation, fatigue, and response bias can influence the obtained thresholds.
PURPOSE
The video describes identification of various artifacts in Humphrey visual field printout and it has some useful teaching points to recognize and learn.
SYNOPSIS
Visual field test is critical for assessment and to document progression of glaucoma, but is prone to errors and artifacts. Fortunately, the patterns of such artifactual field loss are often characteristic and easily recognizable.
HIGHLIGHTS
Several types of errors can lead to inaccurate results. Proper instructions and patient supervision during the test helps to improve the test results. The technician should ensure correct patient's data entry. Careful examination of the obtained data on the printout is essential to detect any errors that can lead to misinterpretation of visual field, false alarms, and wrong clinical conclusion.
VIDEO LINK
https://youtu.be/OWdFk4pWJkM.
Topics: Humans; Artifacts; Physical Examination; Visual Field Tests; Visual Fields
PubMed: 36453382
DOI: 10.4103/ijo.IJO_1487_22 -
BMC Oral Health Sep 2023Intra-oral scans and gypsum cast scans (OS) are widely used in orthodontics, prosthetics, implantology, and orthognathic surgery to plan patient-specific treatments,...
OBJECTIVE
Intra-oral scans and gypsum cast scans (OS) are widely used in orthodontics, prosthetics, implantology, and orthognathic surgery to plan patient-specific treatments, which require teeth segmentations with high accuracy and resolution. Manual teeth segmentation, the gold standard up until now, is time-consuming, tedious, and observer-dependent. This study aims to develop an automated teeth segmentation and labeling system using deep learning.
MATERIAL AND METHODS
As a reference, 1750 OS were manually segmented and labeled. A deep-learning approach based on PointCNN and 3D U-net in combination with a rule-based heuristic algorithm and a combinatorial search algorithm was trained and validated on 1400 OS. Subsequently, the trained algorithm was applied to a test set consisting of 350 OS. The intersection over union (IoU), as a measure of accuracy, was calculated to quantify the degree of similarity between the annotated ground truth and the model predictions.
RESULTS
The model achieved accurate teeth segmentations with a mean IoU score of 0.915. The FDI labels of the teeth were predicted with a mean accuracy of 0.894. The optical inspection showed excellent position agreements between the automatically and manually segmented teeth components. Minor flaws were mostly seen at the edges.
CONCLUSION
The proposed method forms a promising foundation for time-effective and observer-independent teeth segmentation and labeling on intra-oral scans.
CLINICAL SIGNIFICANCE
Deep learning may assist clinicians in virtual treatment planning in orthodontics, prosthetics, implantology, and orthognathic surgery. The impact of using such models in clinical practice should be explored.
Topics: Humans; Deep Learning; Algorithms; Calcium Sulfate; Dental Care; Physical Examination
PubMed: 37670290
DOI: 10.1186/s12903-023-03362-8 -
Biomedical Engineering Online May 2022Falls among older adults have become a global concern. While previous studies have established associations between autonomic function indicator; heart rate variability...
BACKGROUND
Falls among older adults have become a global concern. While previous studies have established associations between autonomic function indicator; heart rate variability (HRV) and blood pressure variability (BPV) with fall recurrence, as well as physical inactivity and psychological disorders as risk factors for falls, the influence of physical activity and psychological status on autonomic dysfunction observed among older fallers has not been adequately investigated. The aim of this study was to evaluate the relationship between psychological disorder and physical performance on the autonomic nervous system (ANS) in older fallers. We hypothesised that older fallers have poorer autonomic function, greater dependency on others and were associated with psychological disorders. Furthermore, we hypothesised that both physical performance and psychological status can contribute to the worsening of the autonomic function among the elderly.
METHODS
In this cross-sectional survey, adults aged ≥ 60 years were recruited. Continuous non-invasive BP was monitored over 5 min of supine and 3 min of standing. Psychological status was assessed in terms of depression, anxiety, stress, and concern about falling, while functional status was measured using time-up-and-go, functional reach, handgrip and Lawton's Instrumental Activities of Daily Life (IADL) scale.
RESULTS
A total of 62 participants were recruited consisting of 37 fallers and 25 non-fallers. Multivariate analysis revealed that Lawton IADL was independently associated with systolic blood pressure variability (SBPV) and diastolic blood pressure variability (DBPV) during both supine (SBPV: r = 0.080, p = 0.025; DBPV: r = 0.064, p = 0.046) and standing (SBPV: r = 0.112, p = 0.008; DBPV: r = 0.105, p = 0.011), while anxiety score was independently associated with SBPV and DBPV during standing (SBPV: r = 0.112, p = 0.009; DBPV: r = 0.105, p = 0.011) as compared to the other parameters.
CONCLUSION
Our findings suggest that fallers had poorer ANS, greater dependence in IADLs, and were more anxious. IADL dependency and anxiety were the most predictive of autonomic dysfunction, and can be used in practice to identify poor autonomic function for the prevention of falls and cardiovascular diseases among older adults.
Topics: Aged; Blood Pressure; Blood Pressure Monitoring, Ambulatory; Cross-Sectional Studies; Hand Strength; Humans; Physical Functional Performance
PubMed: 35513815
DOI: 10.1186/s12938-022-00996-7 -
Journal of Family & Community Medicine 2022Much research has found that smoking is one of the major risk factors for a variety of physical diseases and mental disorders; however, few studies have been conducted...
BACKGROUND
Much research has found that smoking is one of the major risk factors for a variety of physical diseases and mental disorders; however, few studies have been conducted on smoking in Egypt. Furthermore, to the researcher's best knowledge, no study in Egypt has compiled data on smoking prevalence, motives, and levels of nicotine dependency. In order to fill in this gap, the current study has attempted to summarize the situation and construct an accurate picture of smoking in Egypt.
MATERIALS AND METHODS
This cross-sectional study included 2000 Egyptian adults in Fayoum through a multistage cluster sampling technique. For data collection, the Socioeconomic Status Scale was deployed. In addition, Depression, Anxiety, Stress Scale (DASS), the Modified Reasons for Smoking Scale (MRSS), and Fagerstrom Test for Nicotine Dependence (FTND) were used. Data analysis performed using SPSS version 22.0. For qualitative data, Chi-square test was used to determine statistical significance. Bivariate Pearson correlation was used to test for the association between quantitative variables.
RESULTS
Of the total sample of 2000 adults, 40.4% had anxiety and 24.3% had stress, and 19.5% showed severe to extremely severe level of depression. For MRSS, tension reduction or relaxation was found in 46.5% adults while 9.8% had high level of nicotine dependence. There was a statistically significant association between psychometric disorders, on one hand, and both smoking motivation and nicotine dependence, on the other ( < 0.001). The DASS score had a statistically significant correlation with age, smoking duration, nicotine dependence level, and MRSS subscales.
CONCLUSION
Smoking is linked to psychological symptoms and shows a moderate to high level of nicotine dependence, with a higher level of dependency, smoking pleasure, stress reduction/ relaxation, and hand-mouth movement as motives for smoking. Furthermore, there was a correlation between nicotine dependence, on one hand, and depression and stress on the other.
PubMed: 35197723
DOI: 10.4103/jfcm.jfcm_290_21