-
Revue Medicale de Liege Feb 2010Digital clubbing is a clinical sign known for centuries. Though, no theory could yet explain this entire phenomenon, neither in its primary nor its secondary form. This... (Review)
Review
Digital clubbing is a clinical sign known for centuries. Though, no theory could yet explain this entire phenomenon, neither in its primary nor its secondary form. This article reviews the actual hypotheses bringing a plausible explanation, regarding the most current pathologies associated with digital clubbing. A focus is made on pulmonary and digestive pathologies, and particularly cirrhosis. The knowledge of the mechanisms underlying finger clubbing might lead, in the future, to an effective treatment.
Topics: Diagnosis, Differential; Humans; Osteoarthropathy, Secondary Hypertrophic; Physical Examination
PubMed: 20344919
DOI: No ID Found -
Canadian Family Physician Medecin de... Apr 2016To describe updates to the Preventive Care Checklist Form© to help family physicians stay up to date with current preventive health care recommendations. (Review)
Review
OBJECTIVE
To describe updates to the Preventive Care Checklist Form© to help family physicians stay up to date with current preventive health care recommendations.
QUALITY OF EVIDENCE
The Ovid MEDLINE database was searched using specified key words and other terms relevant to the periodic health examination. Secondary sources, such as the Canadian Task Force on Preventive Health Care, the Public Health Agency of Canada, the Trip database, and the Canadian Medical Association Infobase, were also searched. Recommendations for preventive health care for average-risk adults were reviewed. Strong and weak recommendations are presented on the form in bold and italic text, respectively.
MAIN MESSAGE
Updates were made to the form based on the Canadian Task Force on Preventive Health Care recommendations on screening for obesity (2015), cervical cancer (2013), depression (2013), osteoporosis (2013), hypertension (2012), diabetes (2012, 2013), and breast cancer (2011). Updates were made based on recommendations from other Canadian organizations on screening for HIV (2013), screening for sexually transmitted infections (2013), immunizations (2012 to 2014), screening for dyslipidemia (2012), fertility counseling for women (2011, 2012), and screening for colorectal cancer (2010). Some previous recommendations were removed and others lacking evidence were not included.
CONCLUSION
The Preventive Care Checklist Form has been updated with current recommendations to enable family physicians to provide comprehensive, evidence-based care to patients during periodic health examinations.
Topics: Adult; Canada; Checklist; Family Practice; Female; Humans; Male; Physical Examination; Practice Guidelines as Topic; Preventive Health Services
PubMed: 27076540
DOI: No ID Found -
BMJ (Clinical Research Ed.) Aug 2005
Review
Topics: Conjunctival Diseases; Humans; Hyperemia; Medical History Taking; Physical Examination; Referral and Consultation
PubMed: 16110072
DOI: 10.1136/bmj.331.7514.438 -
Physical examination education in graduate medical education--a systematic review of the literature.Journal of General Internal Medicine Aug 2013There is widespread recognition that physical examination (PE) should be taught in Graduate Medical Education (GME), but little is known regarding how to best teach PE... (Review)
Review
OBJECTIVES
There is widespread recognition that physical examination (PE) should be taught in Graduate Medical Education (GME), but little is known regarding how to best teach PE to residents. Deliberate practice fosters expertise in other fields, but its utility in teaching PE is unknown. We systematically reviewed the literature to determine the effectiveness of methods to teach PE in GME, with attention to usage of deliberate practice.
DATA SOURCES
We searched PubMed, ERIC, and EMBASE for English language studies regarding PE education in GME published between January 1951 and December 2012.
STUDY ELIGIBILITY CRITERIA
Seven eligibility criteria were applied to studies of PE education: (1) English language; (2) subjects in GME; (3) description of study population; (4) description of intervention; (5) assessment of efficacy; (6) inclusion of control group; and (7) report of data analysis.
STUDY APPRAISAL AND SYNTHESIS METHODS
We extracted data regarding study quality, type of PE, study population, curricular features, use of deliberate practice, outcomes and assessment methods. Tabulated summaries of studies were reviewed for narrative synthesis.
RESULTS
Fourteen studies met inclusion criteria. The mean Medical Education Research Study Quality Instrument (MERSQI) score was 9.0 out of 18. Most studies (n = 8) included internal medicine residents. Half of the studies used resident interaction with a human examinee as the primary means of teaching PE. Three studies "definitely" and four studies "possibly" used deliberate practice; all but one of these studies demonstrated improved educational outcomes.
LIMITATIONS
We used a non-validated deliberate practice assessment. Given the heterogeneity of assessment modalities, we did not perform a meta-analysis.
CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS
No single strategy for teaching PE in GME is clearly superior to another. Following the principles of deliberate practice and interaction with human examinees may be beneficial in teaching PE; controlled studies including these educational features should be performed to investigate these exploratory findings.
Topics: Clinical Competence; Education, Medical, Graduate; Humans; Physical Examination; Physicians
PubMed: 23568186
DOI: 10.1007/s11606-013-2380-x -
Knee Surgery, Sports Traumatology,... Apr 2017To inventory the examination methods available to assess antero-medial rotational laxity (AMRL) of the knee following medial collateral ligament injury. (Review)
Review
PURPOSE
To inventory the examination methods available to assess antero-medial rotational laxity (AMRL) of the knee following medial collateral ligament injury.
METHODS
Searches were conducted in accordance with the PRISMA guidelines and using four online databases: WEB OF SCIENCE, MEDLINE, EMBASE, and AMED. The Critical Appraisal Skills Programme guidelines for Diagnostic Test Studies were used for the quality assessment of the articles.
RESULTS
A total of 2241 articles were identified from the database searches. From this, four articles were included in the final review. All were case-control studies, considered a combined ACL/MCL injury and had small study populations. Specialised equipment was required in all studies, and one needed additional imaging support before measurements could be taken. Two employed commercially available measuring equipment as part of the assessment process.
CONCLUSION
Clinical assessment of AMRL in relation to a MCL injury remains challenging. Although methods have been developed to support clinical examination, they are limited by a number of factors, including the need for additional time in the clinical environment when setting up equipment, the need for specific equipment to produce and measure rotational movement and imaging support. In addition, there are patient safety concerns from the repeated imaging. A reliable and valid clinical examination remains to be found to truly assess antero-medial rotational laxity of the knee.
LEVEL OF EVIDENCE
IV.
Topics: Arthrometry, Articular; Humans; Joint Instability; Knee Joint; Medial Collateral Ligament, Knee; Physical Examination
PubMed: 27787588
DOI: 10.1007/s00167-016-4362-0 -
Cleveland Clinic Journal of Medicine May 2016Nail lines are a common presenting finding. A thorough inspection of the fingernails and toenails is an integral part of the complete physical examination. An... (Review)
Review
Nail lines are a common presenting finding. A thorough inspection of the fingernails and toenails is an integral part of the complete physical examination. An understanding of basic nail anatomy and familiarity with several basic types of nail line enable the clinician to diagnose and treat nail disorders and to recognize underlying systemic diseases, as each type of nail line has a particular differential diagnosis. The authors review leukonychia striata (white lines), longitudinal melanonychia (brown-black lines), longitudinal erythronychia (red lines), and nail-plate grooves (Beau lines).
Topics: Diagnosis, Differential; Humans; Nail Diseases; Nails; Physical Examination; Pigmentation
PubMed: 27168515
DOI: 10.3949/ccjm.83a.14187 -
The Journal of Headache and Pain Feb 2011Headache is the most common somatic complaint in children and adolescents. The evaluation should include detailed history of children and adolescents completed by... (Review)
Review
Headache is the most common somatic complaint in children and adolescents. The evaluation should include detailed history of children and adolescents completed by detailed general and neurological examinations. Moreover, the possible role of psychological factors, life events and excessively stressful lifestyle in influencing recurrent headache need to be checked. The choice of laboratory tests rests on the differential diagnosis suggested by the history, the character and temporal pattern of the headache, and the physical and neurological examinations. Subjects who have any signs or symptoms of focal/progressive neurological disturbances should be investigated by neuroimaging techniques. The electroencephalogram and other neurophysiological examinations are of limited value in the routine evaluation of headaches. In a primary headache disorder, headache itself is the illness and headache is not attributed to any other disorder (e.g. migraine, tension-type headache, cluster headache and other trigeminal autonomic cephalgias). In secondary headache disorders, headache is the symptom of identifiable structural, metabolic or other abnormality. Red flags include the first or worst headache ever in the life, recent headache onset, increasing severity or frequency, occipital location, awakening from sleep because of headache, headache occurring exclusively in the morning associated with severe vomiting and headache associated with straining. Thus, the differential diagnosis between primary and secondary headaches rests mainly on clinical criteria. A thorough evaluation of headache in children and adolescents is necessary to make the correct diagnosis and initiate treatment, bearing in mind that children with headache are more likely to experience psychosocial adversity and to grow up with an excess of both headache and other physical and psychiatric symptoms and this creates an important healthcare problem for their future life.
Topics: Adolescent; Child; Diagnosis, Differential; Headache Disorders; Humans; Neurology; Pediatrics; Physical Examination; Psychology, Child
PubMed: 21359874
DOI: 10.1007/s10194-011-0297-5 -
Journal of Athletic Training 2014To present athletic trainers with recommendations for the content and administration of the preparticipation physical examination (PPE) as well as considerations for... (Review)
Review
OBJECTIVE
To present athletic trainers with recommendations for the content and administration of the preparticipation physical examination (PPE) as well as considerations for determining safe participation in sports and identifying disqualifying conditions.
BACKGROUND
Preparticipation physical examinations have been used routinely for nearly 40 years. However, considerable debate exists as to their efficacy due to the lack of standardization in the process and the lack of conformity in the information that is gathered. With the continuing rise in sports participation at all levels and the growing number of reported cases of sudden death in organized athletics, the sports medicine community should consider adopting a standardized process for conducting the PPE to protect all parties.
RECOMMENDATIONS
Recommendations are provided to equip the sports medicine community with the tools necessary to conduct the PPE as effectively and efficiently as possible using available scientific evidence and best practices. In addition, the recommendations will help clinicians identify those conditions that may threaten the health and safety of participants in organized sports, may require further evaluation and intervention, or may result in potential disqualification.
Topics: Athletic Injuries; Guidelines as Topic; Humans; Physical Examination; Societies; Sports; Sports Medicine
PubMed: 24499039
DOI: 10.4085/1062-6050-48.6.05 -
International Wound Journal Dec 2007
Topics: Diabetic Foot; Diagnostic Imaging; Female; Forecasting; Humans; Male; Physical Examination; Physician-Patient Relations; Practice Patterns, Physicians'; Risk Assessment; Sensitivity and Specificity; Severity of Illness Index; Time Factors; Wounds and Injuries
PubMed: 18154622
DOI: 10.1111/j.1742-481X.2007.00375.x -
The Western Journal of Medicine Apr 1993
Topics: Education, Medical, Undergraduate; Hospitals; Humans; Medical History Taking; Physical Examination; Physician-Patient Relations
PubMed: 8317135
DOI: No ID Found