Role of clinical context in residents’ physical examination diagnostic accuracy

2011 ◽  
Vol 45 (4) ◽  
pp. 415-421 ◽  
Author(s):  
Matthew Sibbald ◽  
Daniel Panisko ◽  
Rodrigo B. Cavalcanti
Keyword(s):  
Physical Examination ◽  
Diagnostic Accuracy ◽  
Clinical Context

Natriuretic Peptides – Addressing the Dilemma of Heart Failure Management

2011 ◽  
Vol 7 (2) ◽  
pp. 104
Author(s):  
Kenneth McDonald ◽  
Ulf Dahlström ◽  
◽  
Keyword(s):  
Heart Failure ◽  
Physical Examination ◽  
Natriuretic Peptides ◽  
Normal Values ◽  
Outpatient Setting ◽  
Heart Failure Management ◽  
Effective Screening ◽  
Specific Symptoms ◽  
Objective Marker

Heart failure (HF) is characterised by non-specific symptoms and unremarkable physical examination; therefore, the need exists for an available objective marker of HF status. Natriuretic peptides (NPs) are a marker that can aid the dilemmas in present-day HF management. More effective screening for clinical deterioration would include changes in brain natriuretic peptide (BNP) levels. Normal values for BNP, <50–100 pg/ml, have excellent negative predictive value (NPV) in excluding HF as a diagnosis. BNP values that are significantly elevated, e.g. >500 pg/ml, make the diagnosis of HF more likely. There are now established and emerging uses for NPs in managing HF in the community. These include the role of NPs at the time of possible new presentation of HF, its role in prognostication and, finally, the increasing interest in using NPs to guide therapy in the outpatient setting.

scholarly journals Diagnostic Role of 18F-PSMA-1007 PET/CT in Prostate Cancer Staging: A Systematic Review

Diagnostics ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 552
Author(s):  
Salam Awenat ◽  
Arnoldo Piccardo ◽  
Patricia Carvoeiras ◽  
Giovanni Signore ◽  
Luca Giovanella ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Systematic Review ◽  
Diagnostic Accuracy ◽  
Metastatic Disease ◽  
Cancer Staging ◽  
Relevant Information ◽  
Cochrane Library ◽  
Number Of Patients ◽  
Pet Ct

Background: The use of prostate-specific membrane antigen (PSMA)-targeted agents for staging prostate cancer (PCa) patients using positron emission tomography/computed tomography (PET/CT) is increasing worldwide. We performed a systematic review on the role of 18F-PSMA-1007 PET/CT in PCa staging to provide evidence-based data in this setting. Methods: A comprehensive computer literature search of PubMed/MEDLINE and Cochrane Library databases for studies using 18F-PSMA-1007 PET/CT in PCa staging was performed until 31 December 2020. Eligible articles were selected and relevant information was extracted from the original articles by two authors independently. Results: Eight articles (369 patients) evaluating the role of 18F-PSMA-1007 PET/CT in PCa staging were selected. These studies were quite heterogeneous, but, overall, they demonstrated a good diagnostic accuracy of 18F-PSMA-1007 PET/CT in detecting PCa lesions at staging. Overall, higher primary PCa aggressiveness was associated with higher 18F-PSMA-1007 uptake. When compared with other radiological and scintigraphic imaging methods, 18F-PSMA-1007 PET/CT had superior sensitivity in detecting metastatic disease and the highest inter-reader agreement. 18F-PSMA-1007 PET/CT showed similar results in terms of diagnostic accuracy for PCa staging compared with PET/CT with other PSMA-targeted tracers. Dual imaging with multi-parametric magnetic resonance imaging and 18F-PSMA-1007 PET/CT may improve staging of primary PCa. Notably, 18F-PSMA-1007-PET/CT may detect metastatic disease in a significant number of patients with negative standard imaging. Conclusions: 18F-PSMA-1007 PET/CT demonstrated a good accuracy in PCa staging, with similar results compared with other PSMA-targeted radiopharmaceuticals. This method could substitute bone scintigraphy and conventional abdominal imaging for PCa staging. Prospective multicentric studies are needed to confirm these findings.

The essential role of nurses in supporting physical examination in telemedicine: Insights from an interaction analysis of postsurgical consultations in orthopedics

2021 ◽  
Author(s):  
Maria Cherba ◽  
Sylvie Grosjean ◽  
Luc Bonneville ◽  
Isaac Nahon‐Serfaty ◽  
Judith Boileau ◽  
...  
Keyword(s):  
Physical Examination ◽  
Essential Role ◽  
Interaction Analysis

scholarly journals The Role of Hip Abductor Strength in Identifying Older Persons at Risk of Falls: A Diagnostic Accuracy Study

2020 ◽  
Vol Volume 15 ◽  
pp. 645-654 ◽  
Author(s):  
Simone Chantal Gafner ◽  
Caroline Henrice Germaine Bastiaenen ◽  
Serge Ferrari ◽  
Gabriel Gold ◽  
Andrea Trombetti ◽  
...  
Keyword(s):  
At Risk ◽  
Diagnostic Accuracy ◽  
Older Persons ◽  
Diagnostic Accuracy Study ◽  
Risk Of Falls ◽  
Hip Abductor ◽  
Accuracy Study ◽  
Abductor Strength

The Role of Gait Analysis in Clinical Medicine: A Survey of UK Centres

1987 ◽  
Vol 16 (4) ◽  
pp. 221-227 ◽  
Author(s):  
N Messenger ◽  
P Bowker
Keyword(s):  
Gait Analysis ◽  
Clinical Medicine ◽  
Final Analysis ◽  
Clinical Work ◽  
Clinical Context ◽  
Clinical Value ◽  
Analysis Techniques ◽  
Subjective Views ◽  
The Uk

This paper reports the results of a survey carried out to assess the clinical usage currently being made of gait analysis facilities within the UK. Thirty-five centres were circulated with a questionnaire which requested information under four main headings: (i) equipment, (ii) research projects, (iii) clinical service commitments, and (iv) subjective views of the ultimate clinical value of the service. Of the 25 completed questionnaires returned, 16 were suitable for inclusion in the final analysis of data. The survey provided useful data on the equipment and facilities available in each centre together with details of the service available to prospective referring clinicians. Ten centres were considered as being currently involved in some clinical work, with six of these being routinely involved. The respondents generally felt that gait analysis techniques have a clinical context, if not yet routinely, but the numbers of referrals to the centres is still quite small. A number of areas worthy of further work were identified by the respondents. It is hoped that presentation of these results will stimulate dialogue between centres and between clinicians and bioengineers.

scholarly journals Diagnostic accuracy of physical examination findings for midfacial and mandibular fractures

Injury ◽  
2021 ◽  
Author(s):  
Romke Rozema ◽  
Michiel H.J. Doff ◽  
Mostafa El Moumni ◽  
Martijn F. Boomsma ◽  
Frederik K.L. Spijkervet ◽  
...  
Keyword(s):  
Physical Examination ◽  
Diagnostic Accuracy ◽  
Mandibular Fractures

Modern Concepts on the Role of Inflammation in Pulmonary Fibrosis

2011 ◽  
Vol 135 (6) ◽  
pp. 780-788 ◽  
Author(s):  
Robert J. Homer ◽  
Jack A. Elias ◽  
Chun Gun Lee ◽  
Erica Herzog
Keyword(s):  
Cell Death ◽  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Therapeutic Intervention ◽  
Macrophage Polarization ◽  
Critical Evaluation ◽  
Clinical Context ◽  
Disease Biomarkers ◽  
Unpublished Research

Abstract Context.—Idiopathic pulmonary fibrosis is a uniformly lethal disease with limited biomarkers and no proven therapeutic intervention short of lung transplantation. Pulmonary fibrosis at one time was thought to be a result of inflammation in the lung. Although some forms of pulmonary fibrosis may result from inflammation, idiopathic pulmonary fibrosis is currently thought to result from cell death primarily and inflammation secondarily. Objective.—To determine the role of inflammation in pulmonary fibrosis in light of our laboratory's published and unpublished research and published literature. Data Sources.—Review based on our laboratory's published and unpublished experimental data with relevant background and clinical context provided. Conclusions.—Although cell death is central to pulmonary fibrosis, the proper cytokine environment leading to macrophage polarization is also critical. Evaluation of this environment is promising both for the development of disease biomarkers and for targets for therapeutic intervention.

scholarly journals Role of 25 MHz Ultrasound Biomicroscopy in the Detection of Subluxated Lenses

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Mingyu Shi ◽  
Liwei Ma ◽  
Jinsong Zhang ◽  
Qichang Yan
Keyword(s):  
Diagnostic Accuracy ◽  
Ultrasound Biomicroscopy ◽  
Testing Time ◽  
Ciliary Process ◽  
Lens Subluxation ◽  
Linear Distance ◽  
Case Series Study ◽  
Significant Difference ◽  
D Value

Background. The purpose of this observational case series study was to investigate the role of 25 MHz ultrasound biomicroscopy (UBM) in detecting subluxated lenses and compare it with 50 MHz UBM. Methods. 45 patients (49 eyes) with suspected subluxation of the lens and 20 normal volunteers (40 eyes) were included. Different cross-sectional images of the lens position were captured in axial and longitudinal scanning modes using 25 and 50 MHz UBM. The main outcome measurements included the linear distance between the lens equator and ciliary process, the difference value (D-value) between the same cross section of the above bilateral linear distance in the normal and the subluxated subjects, the diagnostic accuracy, and the testing times obtained with 25 and 50 MHz UBM. Results. The position of the lens on axial sections could be clearly shown by using 25 MHz UBM. The D-value of the subluxated eyes was 1-2 mm longer than that of the normal ones. There was a statistically significant difference between 25 and 50 MHz UBM in showing subluxation of the lens, the testing time was significantly faster (2.0 min versus 7.5 min), and the diagnostic accuracy was much higher (98.0% versus 71.4%) with 25 versus 50 MHz UBM. Fifteen eyes with slightly subluxated lens were detected by 25 MHz UBM, and only one eye with slight lens subluxation was detected by 50 MHz UBM. Conclusions. The results indicated that 25 MHz UBM has a greater diagnostic value than 50 MHz UBM in verifying the status of the lens subluxation and can provide reliable and quantitative imaging evidence for clinical use. This trial is registered with ChiCTR–DOD –15007603.

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