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BMC Pediatrics Apr 2015Although adolescent spinal pain increases the risk for chronic back pain in adulthood, most adolescents can be regarded as healthy. The aim of the present study was to...
BACKGROUND
Although adolescent spinal pain increases the risk for chronic back pain in adulthood, most adolescents can be regarded as healthy. The aim of the present study was to provide data on localization, intensity and frequency of adolescent spinal pain and to investigate which physical and psycho-social parameters predict these pain characteristics.
METHOD
On the occasion of Spine Day, an annual event where children and adolescents are examined by chiropractors on a voluntary basis for back problems, 412 adolescents (10 to 16 years) were tested (by questionnaire and physical examination). Pain characteristics (localization, intensity, and frequency) were identified and evaluated using descriptive statistics. Regression analyses were performed to investigate possible influencing psycho-social and physical influence factors.
RESULTS
Adolescents who suffered from pain in more than one spinal area reported higher pain intensity and frequency than those with pain in only one spinal area. Sleep disorders were a significant predictor for pain in more than one spinal area (p < 0.01) as well as a trend for frequent pain (p = 0.06). Adolescents with frequent pain showed impaired balance on one leg standing with closed eyes (p = 0.02).
CONCLUSIONS
Studies on adolescent spinal pain should report data on pain frequency, intensity and localization. Adolescents who present with pain in more than one spinal area or report frequent pain should be followed carefully. Reduced balance with visual deprivation might be a physical indicator of a serious back problem.
Topics: Adolescent; Back Pain; Child; Female; Humans; Male; Pain Measurement; Physical Examination; Retrospective Studies; Surveys and Questionnaires
PubMed: 25886130
DOI: 10.1186/s12887-015-0344-5 -
Radiologia 2023The objective structured clinical examination (OSCE) is a format of examination that enables students to be evaluated in a uniform, standardized, reliable, and objective...
The objective structured clinical examination (OSCE) is a format of examination that enables students to be evaluated in a uniform, standardized, reliable, and objective way. It is carried out in different clinical stations that simulate real clinical situations and scenarios. Numerous universities in Spain and other countries employ this approach for the final examination for medical school students. This update describes the organization, design, and fundamentals for the OSCE, proposing that radiology should form part of multidisciplinary OSCEs to the extent that it forms part of clinical practice. Moreover, it is interesting and opportune to introduce the OSCE in undergraduate and postgraduate training in radiology. Online platforms enable bidimensional OSCEs that are cost-effective in terms of staff, resources, and physical space, although this approach has certain limitations. Virtual world technologies make it possible to reproduce OSCE stations in three-dimensional scenarios; recent experiences in radiology have shown that this approach interests and motivates students and is widely accepted by them.
Topics: Humans; Clinical Competence; Physical Examination; Education, Medical, Undergraduate; Educational Measurement; Diagnostic Imaging
PubMed: 36842786
DOI: 10.1016/j.rxeng.2022.09.006 -
American Family Physician Feb 2018Tremor is an involuntary, rhythmic, oscillatory movement of a body part. It is the most common movement disorder encountered in primary care. The diagnosis of tremor is...
Tremor is an involuntary, rhythmic, oscillatory movement of a body part. It is the most common movement disorder encountered in primary care. The diagnosis of tremor is based on clinical information obtained from the history and physical examination. The most common tremors in patients presenting to primary care physicians are enhanced physiologic tremor, essential tremor, and parkinsonian tremor. All persons have low-amplitude, high-frequency physiologic tremors at rest and during action that are not reported as symptomatic, but can be enhanced by anxiety, medication use, caffeine intake, or fatigue. Features consistent with psychogenic tremor are abrupt onset, spontaneous remission, changing tremor characteristics, and extinction with distraction. Other types of tremor include cerebellar, dystonic, and drug- or metabolic-induced. The first step in evaluating a patient with tremor is to categorize the tremor based on its activation condition, topographic distribution, and frequency. Resting tremors occur in a body part that is relaxed and completely supported against gravity. Action tremors occur with voluntary contraction of a muscle and can be further subdivided into postural, isometric, and kinetic tremors. The most common pathologic tremor is essential tremor, which affects 0.4% to 6% of the population. In one-half of cases, it is transmitted in an autosomal-dominant fashion. More than 70% of patients with Parkinson disease have tremor as the presenting feature. This tremor is typically unilateral, occurs at rest, and becomes less prominent with voluntary movement. If there is diagnostic uncertainty, single-photon emission computed tomography can be used to visualize the integrity of the dopaminergic pathways in the brain, and transcranial ultrasonography may be useful to diagnose Parkinson disease.
Topics: Adult; Aged; Aged, 80 and over; Diagnosis, Differential; Female; Humans; Male; Middle Aged; Parkinson Disease; Physical Examination; Practice Guidelines as Topic; Primary Health Care; Tremor
PubMed: 29431985
DOI: No ID Found -
Family Medicine Sep 2016
Topics: Adult; Emigrants and Immigrants; Family Practice; Female; Humans; Physical Examination; Rape
PubMed: 27655200
DOI: No ID Found -
Internal Medicine (Tokyo, Japan) 2007Among the various diagnostic strategies of chronic obstructive pulmonary disease (COPD), physical diagnosis is the quickest and requires no extra cost. Rapid physical... (Review)
Review
Among the various diagnostic strategies of chronic obstructive pulmonary disease (COPD), physical diagnosis is the quickest and requires no extra cost. Rapid physical diagnosis of COPD in primary care practice can lead to earlier actions of preventive measures and counseling for patients. Further, rapid physical diagnosis of COPD in an emergency department is also crucial for timely use of potentially lifesaving therapy specific for COPD patients. In this review, we will present a broad scope of physical findings for rapid physical diagnosis of COPD.
Topics: Auscultation; Emergency Medical Services; Humans; Palpation; Percussion; Physical Examination; Primary Health Care; Pulmonary Disease, Chronic Obstructive
PubMed: 18057759
DOI: 10.2169/internalmedicine.46.0455 -
Journal of Tissue Viability Nov 2017At present there is no established national minimum data set (MDS) for generic wound assessment in England, which has led to a lack of standardisation and variable... (Review)
Review
BACKGROUND
At present there is no established national minimum data set (MDS) for generic wound assessment in England, which has led to a lack of standardisation and variable assessment criteria being used across the country. This hampers the quality and monitoring of wound healing progress and treatment.
AIM
To establish a generic wound assessment MDS to underpin clinical practice.
METHOD
The project comprised 1) a literature review to provide an overview of wound assessment best practice and identify potential assessment criteria for inclusion in the MDS and 2) a structured consensus study using an adapted Research and Development/University of California at Los Angeles Appropriateness method. This incorporated experts in the wound care field considering the evidence of a literature review and their experience to agree the assessment criteria to be included in the MDS.
RESULTS
The literature review identified 24 papers that contained criteria which might be considered as part of generic wound assessment. From these papers 68 potential assessment items were identified and the expert group agreed that 37 (relating to general health information, baseline wound information, wound assessment parameters, wound symptoms and specialists) should be included in the MDS.
DISCUSSION
Using a structured approach we have developed a generic wound assessment MDS to underpin wound assessment documentation and practice. It is anticipated that the MDS will facilitate a more consistent approach to generic wound assessment practice and support providers and commissioners of care to develop and re-focus services that promote improvements in wound care.
Topics: Consensus; Datasets as Topic; England; Humans; Physical Examination; Wounds and Injuries
PubMed: 29030056
DOI: 10.1016/j.jtv.2017.09.007 -
BMJ (Clinical Research Ed.) Nov 2004
Review
Topics: Adult; Female; Humans; Hypothyroidism; Medical History Taking; Physical Examination
PubMed: 15564259
DOI: 10.1136/bmj.329.7477.1271 -
Medical Education Online Dec 2022Current evidence indicates that undergraduate medical students display deficits in musculoskeletal physical examination skills (MPES). While various instructional...
Current evidence indicates that undergraduate medical students display deficits in musculoskeletal physical examination skills (MPES). While various instructional methods are recommended for teaching clinical skills, effective methods for teaching MPES have not been established. This study compared the effectiveness of a multimodal teaching approach incorporating video-based learning, interactive small-group teaching, hands-on practicing, peer-assisted learning, formative assessment, and constructive feedback with traditional bedside teaching in developing undergraduate orthopedic MPES. Participants were 151 fifth-year medical students divided into two groups. One group received multimodal teaching, and the other received traditional bedside teaching. In both groups, the participants learned how to physically examine the knee and shoulder. The primary outcome was objective structured clinical examination (OSCE) scores, while the secondary outcomes included teaching sessions' total durations, facilitator's demonstration time, participants' practice time, and proportion of students with passing checklist scores and global ratings-based assessments for the two teaching approaches. The multimodal teaching group had significantly higher OSCE scores (checklist scores, global ratings, and passing rates; = 0.02, 0.02, 0.01, respectively) than the comparison group. Individual OSCE component assessments showed significant improvements in the special musculoskeletal physical examination test. The overall duration and amount of participants' hands-on time were significantly longer for the multimodal than for the traditional bedside teaching group = 0.01 and 0.01, respectively), and the facilitator's demonstration time was significantly shorter ( = 0.01). The multimodal learner-centered teaching approach evaluated in this study was effective for teaching MPES. It appeared to maximize learner engagement through enhancing interactions and providing increased time to engage in hands-on practice. This teaching approach improved MPES levels, maximized teaching efficiency for scenarios with limited instruction time and resources, and enhanced competency of undergraduate medical students in performing special musculoskeletal physical examinations compared to traditional bedside teaching.
Topics: Clinical Competence; Education, Medical, Undergraduate; Humans; Orthopedics; Physical Examination; Students, Medical
PubMed: 35993497
DOI: 10.1080/10872981.2022.2114134 -
Journal of General Internal Medicine Jun 2008The Standards for Reporting of Diagnostic Accuracy (STARD) statement provided guidelines for investigators conducting diagnostic accuracy studies. We reviewed each item...
OBJECTIVE
The Standards for Reporting of Diagnostic Accuracy (STARD) statement provided guidelines for investigators conducting diagnostic accuracy studies. We reviewed each item in the statement for its applicability to clinical examination diagnostic accuracy research, viewing each discrete aspect of the history and physical examination as a diagnostic test.
SETTING
Nonsystematic review of the STARD statement.
INTERVENTIONS
Two former STARD Group participants and 1 editor of a journal series on clinical examination research reviewed each STARD item. Suggested interpretations and comments were shared to develop consensus.
MEASUREMENTS AND MAIN RESULTS
The STARD Statement applies generally well to clinical examination diagnostic accuracy studies. Three items are the most important for clinical examination diagnostic accuracy studies, and investigators should pay particular attention to their requirements: describe carefully the patient recruitment process, describe participant sampling and address if patients were from a consecutive series, and describe whether the clinicians were masked to the reference standard tests and whether the interpretation of the reference standard test was masked to the clinical examination components or overall clinical impression. The consideration of these and the other STARD items in clinical examination diagnostic research studies would improve the quality of investigations and strengthen conclusions reached by practicing clinicians.
CONCLUSIONS
The STARD statement provides a very useful framework for diagnostic accuracy studies. The group correctly anticipated that there would be nuances applicable to studies of the clinical examination. We offer guidance that should enhance their usefulness to investigators embarking on original studies of a patient's history and physical examination.
Topics: Humans; Medical History Taking; Physical Examination; Practice Guidelines as Topic; Publishing; Research Design
PubMed: 18347878
DOI: 10.1007/s11606-008-0583-3 -
Journal of Feline Medicine and Surgery Jan 2019Systemic hypertension is common in older cats and can result in damage to organs with a rich arteriolar supply such as the eyes, kidneys, myocardium and brain.... (Review)
Review
PRACTICAL RELEVANCE
Systemic hypertension is common in older cats and can result in damage to organs with a rich arteriolar supply such as the eyes, kidneys, myocardium and brain. Hypertensive disease in these organs is known as target organ damage (TOD). Disease in the eye resulting from hypertension is the most easily identifiable form of TOD and can often be the reason the cat is presented to the veterinarian. Routine blood pressure measurement and fundic examination allows cats with hypertensive ocular lesions to be detected early in the course of the disease, when the lesions have the best chance of responding to treatment.
CLINICAL CHALLENGES
Detecting early evidence of TOD in the fundus requires a veterinarian to be competent in recognising lesions associated with mild hypertensive disease, as well as the more easily recognised advanced lesions that frequently result in impaired vision and blindness.
AUDIENCE
This review is written for all veterinarians who treat cats. It provides information and images to facilitate and guide veterinarians performing fundoscopy in cats, in particular in those over 7 years of age, with the aim of diagnosing hypertensive ocular lesions when they are present.
EQUIPMENT
The clinical manifestations of hypertensive ocular disease can be detected non-invasively with inexpensive equipment. A summary of the equipment available for general practitioners to perform fundoscopy is provided.
EVIDENCE BASE
This is a comprehensive review of the literature on hypertensive ocular disease in cats. The author has also included images of hypertensive ocular lesions taken in general practice to highlight the variety of lesions that can be detected.
Topics: Animals; Blood Pressure Determination; Cat Diseases; Cats; Early Diagnosis; Eye Diseases; Humans; Hypertension; Physical Examination
PubMed: 30763152
DOI: 10.1177/1098612X18818668