P182 Is it useful to perform a full physical examination in asymptomatic patients with late syphilis?

Objective: Owing to its high sensitivity and specificity, and because it is widely available, transvaginal ultrasonography is the first-line imaging test of choice used for the diagnosis of endometriosis. Ultrasonographic findings evaluated in conjunction with symptoms and signs may improve the diagnosis of endometriosis. Therefore, we hypothesized that transvaginal ultrasonography combined with physical examinations performed by physicians could predict endometriosis better in patients with symptoms suggestive of endometriosis compared with asymptomatic patients at presentation.Study Design: In this retrospective cohort study, the first subjective impression obtained from the history, physical examination, and transvaginal ultrasonography performed by the physician during the first visit in the outpatient clinic was taken into consideration. Patients who underwent surgery with the indication of ovarian mass were divided into two groups according to their admission types; symptomatic and asymptomatic.Results: The number of patients reported to have endometriosis histopathologically was 138;132 were in the premenopausal period (symptomatic group n=101, asymptomatic group n=31) and 6 were in the postmenopausal period (symptomatic group n=1, asymptomatic group n=5). The positive predictive value and positive likelihood ratio of the combination of pelvic examination and transvaginal ultrasonography in premenopausal symptomatic and asymptomatic patients, and postmenopausal symptomatic and asymptomatic patients were 97.8%, 11.5; 47.3%, 6.9; 25.0%, 4.6; and 11.1%, 2.3, respectively.Conclusion: The diagnostic performance of transvaginal ultrasonography in combination with physical examination in patients with asymptomatic endometriosis cannot reach the diagnostic accuracy of physical examination combined with transvaginal ultrasonography in patients with endometriosis who present with symptoms.

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Role of anxiety and depression in adolescents with chest pain referred to a cardiology clinic

Cardiology in the Young ◽

10.1017/s1047951116000238 ◽

2016 ◽

Vol 27 (1) ◽

pp. 125-130 ◽

Cited By ~ 7

Author(s):

Zahra Khairandish ◽

Leila Jamali ◽

Saeedeh Haghbin

Keyword(s):

Chest Pain ◽

Physical Examination ◽

Normal Population ◽

Severe Depression ◽

Anxiety And Depression ◽

Detailed History ◽

Significant Difference ◽

Cardiology Clinic ◽

Full Physical Examination

AbstractBackgroundWe carried out this study in order to evaluate the causes of chest pain in teenagers and the role of anxiety and depression in this age group compared with the normal population.MethodsIn this prospective case–control study, all patients aged 11–18 years with chest pain and no history of trauma and referred to a paediatric cardiology clinic from March, 2009–April, 2010 were selected. A chest pain protocol including a detailed history, full physical examination, required blood tests, electrocardiography, and echocardiography was performed for all. The presence of depression and anxiety and their severity were assessed by Beck questionnaires. The patients were compared with age- and sex-matched, randomly selected healthy controls.ResultsIn total, 194 patients with a mean age of 14±2 years were selected. The most frequent presentation was idiopathic chest pain (43.3%), followed by the psychological group (29.9%). These groups had no abnormal points in history, physical, and para-clinical tests. Moderate-to-severe depression was found in 45.9% in the patients group, compared with 17.6% of controls, which was statistically significant (p=0.016). Moreover, anxiety was detected in 67.5% of patients versus 15.4% in controls, which is a statistically significant difference (p=0.009). Cardiac chest pain with 9.27% was the most common type of organic causes.ConclusionChest pain during teenage is more prevalent, but not risky. Undergoing a detailed history and full physical examination can help diagnose the causes in the majority of cases. Given the prevalence of a psychological group as well as role of anxiety and depression in most patients, referring to a psychiatrist is suggested.

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The electrocardiogram as an adjunct in diagnosing congenital coronary arterial anomalies

Cardiology in the Young ◽

10.1017/s1047951110001101 ◽

2010 ◽

Vol 20 (S3) ◽

pp. 59-67 ◽

Cited By ~ 4

Author(s):

Mitchell Cohen ◽

Stuart Berger

Keyword(s):

Coronary Artery ◽

Physical Examination ◽

Coronary Arteries ◽

Aortic Sinus ◽

Complete Evaluation ◽

The Past ◽

Extensive Evaluation ◽

Asymptomatic Patients ◽

Arterial Anomaly ◽

Arterial Anomalies

AbstractCongenital coronary arterial abnormalities as isolated lesions are exceedingly rare. The electrocardiogram, while a reasonable adjunct in the diagnosis of coronary arterial abnormalities, should not supplant a good history and physical examination. Careful attention must be devoted to any signs or symptoms of ischaemic pain in the chest or syncope, which must not be overlooked. Exertional pain in the chest and exertional syncope should prompt an extensive evaluation by both the echocardiographer and the electrophysiologist. Clearance for participation in sports should be curtailed until a complete evaluation has ruled out the presence of any of the following disorders: a channelopathic mutation, a cardiomyopathy, or a congenital coronary arterial anomaly. Major abnormalities in the coronary arteries may present in the first few months of life or remain dormant until the exertional demands of adolescence unmask symptoms of myocardial ischaemia. Congenital coronary arterial anomalies may be analysed in the following major diagnostic groups: anomalous origin of the left coronary artery from the pulmonary artery, anomalous aortic origin of a coronary artery from the wrong aortic sinus of Valsalva, atresia of the left main coronary artery, myocardial bridges, and coronary arterial fistulas. The advent of state-of-the-art modalities of imaging seems, at times, to have supplanted the electrocardiogram in making the diagnosis of potentially serious coronary artery abnormalities, especially in asymptomatic patients. However, as is also the case for a detailed history and physical examination, the electrocardiogram provides a potentially insightful look at the coronary arteries. Furthermore, the past decade has witnessed an increase in the use of the electrocardiogram as a screening tool in the assessment of the risk of sudden cardiac death in athletes in high school.

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High prevalence of risk factors for physical illness in a long-stay psychiatric unit

Irish Journal of Psychological Medicine ◽

10.1017/s0790966700010223 ◽

2007 ◽

Vol 24 (2) ◽

pp. 55-58 ◽

Cited By ~ 5

Author(s):

Sinead O'Brien ◽

Enda Devitt ◽

Mohamed Ahmed ◽

Colm McDonald

Keyword(s):

Risk Factors ◽

Metabolic Syndrome ◽

Physical Examination ◽

Psychiatric Patients ◽

Physical Illness ◽

Psychiatric Unit ◽

The Metabolic Syndrome ◽

High Prevalence ◽

Full Physical Examination ◽

Physical Risk Factors

AbstractObjective: The aim of this study was to determine the prevalence of risk factors for physical illness in a long stay psychiatric unit, where all care (both psychiatric and physical) is provided by the psychiatric team.Method: All patients in the long-stay ward had a full physical examination including calculation of BMI. All patients had blood sampling including FBC, U&E, LFTs, TFTs, lipid profile (total cholesterol, triglycerides, HDL and LDL), glucose, HbA1c, and prolactin. ATP111 criteria were used to determine the presence of the metabolic syndrome.Results: We found the mean number of comorbid medical diagnosis was 2.7. The prevalence of metabolic syndrome was 40.7% (44.4% of females and 24.1% of males). The prevalence of obesity was 51%, and 51% also had a total cholesterols in excess of 5.0mmol/l. Prolactin was elevated in two-thirds of female patients.Conclusion: We conclude that the annual physical examination is of limited value in long-stay psychiatric unit. The high prevalence of physical illness and physical risk factors warrants primary care involvement in screening and treatment of long-stay psychiatric patients.

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Prevalence of cam-type deformities of the hip in asymptomatic adults

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967114s00251 ◽

2014 ◽

Vol 2 (12_suppl4) ◽

pp. 2325967114S0025

Author(s):

Tomás Vilaseca ◽

María Belén Orlowski ◽

Jorge Chahla ◽

Gustavo Gomez Rodriguez ◽

Damián Arroquy ◽

...

Keyword(s):

General Population ◽

Physical Examination ◽

Femoroacetabular Impingement ◽

High Frequency ◽

Clinical Symptoms ◽

Angle Measurement ◽

Lateral Radiograph ◽

Asymptomatic Patients ◽

Α Angle ◽

Imaging Signs

Objectives: The prevalence of asymptomatic femoroacetabular impingement (FAI) is unknown in the general population. The purpose of this study is to determine the prevalence of cam-type deformities in asymptomatic persons. Methods: We evaluated 84 volunteers without symptoms of FAI, which underwent a lateral radiograph of both hips. To determine the presence of cam type deformities, α-angle measurement was used. An α-angle > 50 ° indicates the presence of cam type deformity. Results: The average age was 28.7 years, with 18 females and 66 males. Of the 84 volunteers, 16 (19%) had an α-angle> 50 °, while the remaining 68 patients had α-angle <50 °. We found the presence of a cam- type deformity in 22.7% of males and 5.5% of women. Conclusion: Our results are consistent with the literature reviewed, finding a prevalence of 13.9 to 24.7% in men and in women 4-5.5% according to different authors. The high frequency of cam-type deformities in asymptomatic patients suggests that a high α-angle itself not only ensures the presence of symptoms or progression to osteoarthritis. Therefore, we hold that this finding should be complemented by physical examination, clinical symptoms and other imaging signs when taking decisions regarding the therapeutic management.

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Evaluation of the Diagnostic Performance of Physical Examination Combined with Transvaginal Ultrasonography in Patients with Endometriosis

Gynecology Obstetrics and Reproductive Medicine ◽

10.21613/gorm.2019.901 ◽

2019 ◽

pp. 1

Author(s):

Talha Tiryaki ◽

Tolga Karacan ◽

Seyma Yesiralioglu ◽

Eser Ozyurek ◽

Huseyin Kiyak ◽

...

Keyword(s):

Physical Examination ◽

Diagnostic Performance ◽

Positive Likelihood Ratio ◽

High Sensitivity ◽

Transvaginal Ultrasonography ◽

Asymptomatic Group ◽

Subjective Impression ◽

Symptomatic Group ◽

Asymptomatic Patients ◽

Number Of Patients

Objective: Owing to its high sensitivity and specificity, and because it is widely available, transvaginal ultrasonography is the first-line imaging test of choice used for the diagnosis of endometriosis. Ultrasonographic findings evaluated in conjunction with symptoms and signs may improve the diagnosis of endometriosis. Therefore, we hypothesized that transvaginal ultrasonography combined with physical examinations performed by physicians could predict endometriosis better in patients with symptoms suggestive of endometriosis compared with asymptomatic patients at presentation.Study Design: In this retrospective cohort study, the first subjective impression obtained from the history, physical examination, and transvaginal ultrasonography performed by the physician during the first visit in the outpatient clinic was taken into consideration. Patients who underwent surgery with the indication of ovarian mass were divided into two groups according to their admission types; symptomatic and asymptomatic.Results: The number of patients reported to have endometriosis histopathologically was 138;132 were in the premenopausal period (symptomatic group n=101, asymptomatic group n=31) and 6 were in the postmenopausal period (symptomatic group n=1, asymptomatic group n=5). The positive predictive value and positive likelihood ratio of the combination of pelvic examination and transvaginal ultrasonography in premenopausal symptomatic and asymptomatic patients, and postmenopausal symptomatic and asymptomatic patients were 97.8%, 11.5; 47.3%, 6.9; 25.0%, 4.6; and 11.1%, 2.3, respectively.Conclusion: The diagnostic performance of transvaginal ultrasonography in combination with physical examination in patients with asymptomatic endometriosis cannot reach the diagnostic accuracy of physical examination combined with transvaginal ultrasonography in patients with endometriosis who present with symptoms.

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A Study of Pulse, Tongue, and Abdominal Palpation Signs as Measured by Kampo Medicine Diagnostic Techniques on Subjects who Received a Full Physical Examination.

Kampo Medicine ◽

10.3937/kampomed.44.403 ◽

1994 ◽

Vol 44 (3) ◽

pp. 403-413

Author(s):

Hiroyuki NINOMIYA ◽

Hiroyori TOSA ◽

Yutaka SHIMADA ◽

Eisuke KANAKI ◽

Hiromichi OKUDA ◽

...

Keyword(s):

Physical Examination ◽

Diagnostic Techniques ◽

Kampo Medicine ◽

Abdominal Palpation ◽

Full Physical Examination

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Incidence of previously undetected disease in routine paediatric otolaryngology admissions

The Journal of Laryngology & Otology ◽

10.1017/s0022215100134255 ◽

1996 ◽

Vol 110 (6) ◽

pp. 557-558

Author(s):

H. Zeitoun ◽

P. Robinson

Keyword(s):

Risk Factors ◽

Physical Examination ◽

Medical History ◽

Diagnostic Yield ◽

House Officer ◽

Suitable Alternative ◽

Educational Value ◽

Cardiac Condition ◽

Full Physical Examination ◽

Operative Assessment

AbstractThe process of clerking routine pre-operative admissions involves the house officer taking a full medical history and performing a full physical examination. The diagnostic yield is thought to be low, and the educational value to the house officer is also small. This study addresses the question as to whether routine physical examination is always indicated.One hundred and nine children admitted for routine Otolaryngology procedures were prospectively studied to identify the importance of examination in the pre-operative assessment of patients.The results showed that 51 per cent of the children admitted had risk factors. The medical history was sufficient to identify these risk factors in all patients with the exception of one cardiac condition.This study concludes that a suitable alternative to the current process of clerking such as a standardized nurse history could be safely and efficiently undertaken. Eliminating the tiny percentage of previously unrecognized disease would be a prerequisite for such a change.

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Haematospermia

International Journal of STD & AIDS ◽

10.1177/095646249200300501 ◽

1992 ◽

Vol 3 (5) ◽

pp. 313-315 ◽

Cited By ~ 1

Author(s):

J Shervington ◽

K W Radcliffe

Keyword(s):

Physical Examination ◽

Sexually Transmitted Disease ◽

Transmitted Disease ◽

Large Series ◽

Sexually Transmitted ◽

Rectal Examination ◽

Urological Symptoms ◽

Full Physical Examination ◽

Serious Disease

Haematospermia, blood in the ejaculate, is a symptom which provokes great anxiety in patients due to fears of malignant or sexually transmitted disease. However, there is no evidence from the published literature to associate it with any serious pathology. The large series of cases indicate that investigation is unproductive and that patients do not develop serious disease even after prolonged follow-up. Patients presenting with haematospermia warrant a full physical examination, including rectal examination, but in the absence of physical signs they should then be strongly reassured. Further investigation is unneccessary. Coexistent urological symptoms should be investigated appropriately.

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