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Sample records for respiratory physical examination

  1. Evaluation of the educational value of YouTube videos about physical examination of the cardiovascular and respiratory systems.

    Science.gov (United States)

    Azer, Samy A; Algrain, Hala A; AlKhelaif, Rana A; AlEshaiwi, Sarah M

    2013-11-13

    A number of studies have evaluated the educational contents of videos on YouTube. However, little analysis has been done on videos about physical examination. This study aimed to analyze YouTube videos about physical examination of the cardiovascular and respiratory systems. It was hypothesized that the educational standards of videos on YouTube would vary significantly. During the period from November 2, 2011 to December 2, 2011, YouTube was searched by three assessors for videos covering the clinical examination of the cardiovascular and respiratory systems. For each video, the following information was collected: title, authors, duration, number of viewers, and total number of days on YouTube. Using criteria comprising content, technical authority, and pedagogy parameters, videos were rated independently by three assessors and grouped into educationally useful and non-useful videos. A total of 1920 videos were screened. Only relevant videos covering the examination of adults in the English language were identified (n=56). Of these, 20 were found to be relevant to cardiovascular examinations and 36 to respiratory examinations. Further analysis revealed that 9 provided useful information on cardiovascular examinations and 7 on respiratory examinations: scoring mean 14.9 (SD 0.33) and mean 15.0 (SD 0.00), respectively. The other videos, 11 covering cardiovascular and 29 on respiratory examinations, were not useful educationally, scoring mean 11.1 (SD 1.08) and mean 11.2 (SD 1.29), respectively. The differences between these two categories were significant (P.86. A small number of videos about physical examination of the cardiovascular and respiratory systems were identified as educationally useful; these videos can be used by medical students for independent learning and by clinical teachers as learning resources. The scoring system utilized by this study is simple, easy to apply, and could be used by other researchers on similar topics.

  2. Evaluation of the Educational Value of YouTube Videos About Physical Examination of the Cardiovascular and Respiratory Systems

    OpenAIRE

    Azer, Samy A; AlGrain, Hala A; AlKhelaif, Rana A; AlEshaiwi, Sarah M

    2013-01-01

    Background A number of studies have evaluated the educational contents of videos on YouTube. However, little analysis has been done on videos about physical examination. Objective This study aimed to analyze YouTube videos about physical examination of the cardiovascular and respiratory systems. It was hypothesized that the educational standards of videos on YouTube would vary significantly. Methods During the period from November 2, 2011 to December 2, 2011, YouTube was searched by three ass...

  3. Does respiratory muscle training increase physical performance?

    Science.gov (United States)

    Sperlich, Billy; Fricke, Hannes; de Marées, Markus; Linville, John W; Mester, Joachim

    2009-09-01

    Special force units and military personnel undergo demanding physical exercise and might benefit from high-intensity respiratory muscle training (RMT) by increasing their endurance performance. This study examined the effects of a 6-week high-intensity RMT on running performance and oxygen uptake (VO2max) in a group of German Special Force Squad members. 17 participants were randomly assigned to a training or control group. Baseline and post-testing included a ramp test, as well as an incremental test on a treadmill, performed to physical exhaustion. VO2, respiratory exchange ratio, and heart rate were measured breath by breath. Furthermore, maximum running speed (V(max)), 4 mmol x 1(-1) lactate threshold (V4) and perception of respiratory effort were determined. During pulmonary testing, sustained maximum inspiratory and expiratory pressure (PI(max) and PE(max)) were obtained. RMT was performed daily at approximately 90% PI(max) for 6 weeks with 2 x 30 breath cycles using an Ultrabreathe lung trainer. No statistical differences were detected between the groups for any parameter after RMT. High-intensity RMT did not show any benefits on VO2max and endurance performance and are unlikely to be of benefit to military or paramilitary training programs for an increase in endurance performance.

  4. Physical activity and respiratory muscle strength in elderly: a systematic review

    Directory of Open Access Journals (Sweden)

    Fabio Dutra Pereira

    Full Text Available Introduction The aging will inevitably bring some kind of functional decline in elderly, sarcopenia in this sense stands out because it damages the muscle function and extend also to the respiratory muscles. Objective Systematically review studies that have sought to compare the strength of respiratory muscles between sedentary and physically active elderly in training programs nonspecific respiratory musculature. Materials and methods From the descriptors motor activity, respiratory muscles and elderly, the databases LILACS, MedLine, Cochrane, PEDro, Scirus and Redalyc were consulted. Results Of 1.263 experiments available in said databases, 12 were recovered and 6 were selected due they meet all the inclusion criteria and selection requirements. Conclusion Physical activity programs offered by the selected studies led physically active elderly to have respiratory muscle strength statistically higher than the sedentary. However, this condition did not expressed itself as security to these elderly to present strength levels above of the minimum predictive of normality.

  5. Role of fluorographic examinations in diagnosis of respiratory system diseases

    International Nuclear Information System (INIS)

    Vil'derman, A.M.; Tsurkan, E.P.; Moskovchuk, A.F.

    1984-01-01

    Materials are considered on the role of fluorography in diagnosis of posttuberculous changes and chromic respiratory system diseases during total epidemiologic examination of 7791 adults from urban and rural population. A scheme is developed that characterize diagnosed pathology of respiratory organs with references to medical establishments rendering medical supervision and forms of supervision. It is shown that fluorograhic examination of the population provide an early diagnosis of both tuberculosis, neoplastic diseases and nonspecific pulmonary diseases that have no visible clinical symptomatology

  6. RESPIRATORY GYMNASTICS AS A REHABILITATION MEANS FOR THE PRESCHOOL CHILDREN WITH THE RESPIRATORY PATHOLOGY

    Directory of Open Access Journals (Sweden)

    T.A. Shemyakina

    2007-01-01

    Full Text Available The researchers analyzed the efficacy of the new medical technology aimed at rehabilitation of the preschool children with the respiratory pathology. 177 children aged between 2 and 7 with recurrent respiratory diseases, bronchial asthma or chronic pathology of the end organs have been examined for 9 months. It was uncovered that among children (n = 90, who performed the sets of the therapeutic physical training and respiratory gymnastics according to the methods developed by the authors, the recurrence of the acute respiratory diseases and exacerbations of bronchial asthma was lower by 1,83 and 1,86 timers respectively. Besides, among children of this group the researchers noted the significant improvement of the physical qualities, spirometric indices and cytological picture of the substance removed from the nasal cavity if compared with the children from the screening group (n = 87, who performed the sets of the conventional gymnastics at the physical training lessons. Thus, the researchers proved the high efficacy of the proposed technology for the rehabilitation of the children, suffering from the chronic respiratory pathology.Key words: acute respiratory diseases, asthma, therapeutic physical training, respiratory gymnastics, children.

  7. Examination of respiratory tract in workers occupationally exposed to beryllium

    International Nuclear Information System (INIS)

    Cianciara, M.; Swiatkowski, J.

    1989-01-01

    In a group (30) occupationally exposed to beryllium below the Maximum Allowed Concentration, deviations from the norm were found in 13% of chest x rays and impairments of lung ventilatory reserves in 46%. The low intensity and non-specific character of the changes did not allow confirmation of connection with occupational exposure. Radiological examination of the lungs, expanded functional testing of the respiratory system and measurements of blood gases are recommended to identify workers with respiratory changes at an early stage. (UK)

  8. The Outpatient Physical Examination.

    Science.gov (United States)

    Artandi, Maja K; Stewart, Rosalyn W

    2018-05-01

    The physical examination in the outpatient setting is a valuable tool. Even in settings where there is lack of evidence, such as the annual physical examination of an asymptomatic adult, the physical examination is beneficial for the physician-patient relationship. When a patient has specific symptoms, the physical examination-in addition to a thorough history-can help narrow down, or in many cases establish, a diagnosis. In a time where imaging and laboratory tests are easily available, but are expensive and can be invasive, a skilled physical examination remains an important component of patient evaluation. Copyright © 2018 Elsevier Inc. All rights reserved.

  9. Method of X-ray examination of upper respiratory tracts

    International Nuclear Information System (INIS)

    Portnoj, L.M.; Surenchik, V.I.; Shuster, M.A.; Sal'nikova, Eh.A.

    1982-01-01

    Method of X-ray examination of upper respiratory tracts by radiography both in direct and lateral projection with an introduction of radiocontrast media through tracheostoma is described. The main objective of the invention is to improve accuracy of diagnostics of larynx and trachea cicatrix structures in children. The objective is attained by the examination under general anesthesia; barium sulfate is simultaneously introduced through laryngoscope and tracheostoma, and polypositional radiography is accomplished just in the moment of air introduction under 130-170 mm Hg pressure in the amounts of 60-200 ml

  10. A 24-h assessment of physical activity and cardio-respiratory fitness among female hospital cleaners

    DEFF Research Database (Denmark)

    Larsen, Mette Korshøj; Krustrup, Peter; Jespersen, Tobias

    2013-01-01

    measured. The methods were feasible for the objective 24-h sampling of physical activity and cardio-respiratory fitness among cleaners. Measurements showed that the cleaners walked 20,198 ± 4,627 steps per day. During working hours, the average cardio-respiratory load was 25 ± 6% of heart rate reserve (HRR......). The cleaners had a low estimated cardio-respiratory fitness (34 mlO2/kg/min), a high BMI (50%, >25 kg/m(2)) and blood pressure (50%, >120/>80 mmHg). The high amount of steps, the relatively high cardiovascular load at work and low cardio-respiratory fitness illustrate the need for further investigation...... of the relationship between physical activity at work and in leisure, and cardiovascular health in this population. Practitioner Summary: This study evaluated the feasibility of methods for objective 24-h sampling of physical activity among cleaners; the methods used were found to be feasible. The cleaners had a high...

  11. The Hypothesis-Driven Physical Examination.

    Science.gov (United States)

    Garibaldi, Brian T; Olson, Andrew P J

    2018-05-01

    The physical examination remains a vital part of the clinical encounter. However, physical examination skills have declined in recent years, in part because of decreased time at the bedside. Many clinicians question the relevance of physical examinations in the age of technology. A hypothesis-driven approach to teaching and practicing the physical examination emphasizes the performance of maneuvers that can alter the likelihood of disease. Likelihood ratios are diagnostic weights that allow clinicians to estimate the post-probability of disease. This hypothesis-driven approach to the physical examination increases its value and efficiency, while preserving its cultural role in the patient-physician relationship. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Hypothesis-driven physical examination curriculum.

    Science.gov (United States)

    Allen, Sharon; Olson, Andrew; Menk, Jeremiah; Nixon, James

    2017-12-01

    Medical students traditionally learn physical examination skills as a rote list of manoeuvres. Alternatives like hypothesis-driven physical examination (HDPE) may promote students' understanding of the contribution of physical examination to diagnostic reasoning. We sought to determine whether first-year medical students can effectively learn to perform a physical examination using an HDPE approach, and then tailor the examination to specific clinical scenarios. Medical students traditionally learn physical examination skills as a rote list of manoeuvres CONTEXT: First-year medical students at the University of Minnesota were taught both traditional and HDPE approaches during a required 17-week clinical skills course in their first semester. The end-of-course evaluation assessed HDPE skills: students were assigned one of two cardiopulmonary cases. Each case included two diagnostic hypotheses. During an interaction with a standardised patient, students were asked to select physical examination manoeuvres in order to make a final diagnosis. Items were weighted and selection order was recorded. First-year students with minimal pathophysiology performed well. All students selected the correct diagnosis. Importantly, students varied the order when selecting examination manoeuvres depending on the diagnoses under consideration, demonstrating early clinical decision-making skills. An early introduction to HDPE may reinforce physical examination skills for hypothesis generation and testing, and can foster early clinical decision-making skills. This has important implications for further research in physical examination instruction. © 2016 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

  13. Modern approaches to physical rehabilitation of children, who often suffer from acute respiratory infections.

    Directory of Open Access Journals (Sweden)

    Khrystova T.E.

    2012-06-01

    Full Text Available There it is described a comprehensive program of physical rehabilitation, which aims at the prevention of acute respiratory diseases in children of primary school age. The research involved 106 children aged 6-9 years. Comprehensive program of physical rehabilitation included: aromafitotherapy and cryomassage of feet. The research proves that using of the mentioned methods leads to improving health, a significant decrease in throat hyperemia, cough and nasal discharge. It also helps to normalize the indices of breathing and physical development of children. More visible effect was observed while using the essential oils of sage and composition of essential oils (sage, lavender, mint. It is proved that the use of aromafitotherapy and cryomassage of feet helps to reduce the frequency of acute respiratory infections and exacerbations of chronic diseases of children upper respiratory organs at age of 6-12 months. It significantly reduces the number of days when children have to be absent at school because of illness.

  14. The respiratory practical persons: new understanding and approaches.

    Directory of Open Access Journals (Sweden)

    Ruslanov D.V.

    2011-02-01

    Full Text Available It is analysed modern information about existent respiratory practices. The methodological, physiological and psychological aspects of respiratory practices are examined. 2 groups of students of higher humanitarian institute are participated in experiment: healthy (students of basic group, n1=180 and with different chronic pathology in the stage of remission (students of group of medical physical education, n2=50. Duration of experiment made about two months. Frequency of the controlled respiratory practice - 1-2 times per a week. The algorithm of respiratory practice is presented. Exercises and recommendations are resulted on their application.

  15. Does Exercise Alter Immune Function and Respiratory Infections?

    Science.gov (United States)

    Nieman, David C.

    2001-01-01

    This paper examines whether physical activity influences immune function as a consequence risk of infection from the common cold and other upper respiratory tract infections (URTI) and whether the immune system responds differently to moderate versus intense physical exertion. Research indicates that people who participate in regular moderate…

  16. The psychiatric inpatient physical health assessment sheet (PIPHAS): a useful tool to improve the speed, efficiency, and documentation of physical examination in new psychiatric inpatients.

    Science.gov (United States)

    Pettipher, Alexander; Ovens, Richard

    2015-01-01

    There is increased morbidity and mortality among patients suffering from mental illness. This is believed to be multi-factorial. Poor access to healthcare, the stigma of mental illness, reduced clinic attendance, lifestyle factors, and side effects of medications are cited as possible contributing factors. It is therefore vital to perform a physical examination to identify previously undiagnosed conditions during the admission of a psychiatric inpatient. The Royal College of Psychiatrists recommends that all patients admitted to a psychiatric hospital should receive a full physical examination on admission, or within twenty-four hours of admission. A snapshot audit was carried out at Prospect Park Hospital in Reading, which highlighted that The Royal College of Psychiatrist's recommendation, along with Trust guidelines regarding physical examination were not being met, with only 78 out of 111 patients (70.3%) undergoing an examination during their admission. In addition to this, examinations were often poorly documented and not covering all examination domains. A psychiatric inpatient physical health assessment sheet (PIPHAS) was designed and introduced, providing a quick and standardised approach to the documentation of a physical examination. After the intervention was put into practice, its impact was assessed by performing a retrospective review of the admission clerking notes of the next 100 admissions to Prospect Park Hospital. Following the introduction of the PIPHAS form there was an increase in the number of patients undergoing physical examination on admission to hospital (75 out of 100 patients, 75%). There was also an increase in the thorough documentation of all examination domains (e.g. respiratory examination) for patients that had a completed PIPHAS form scanned within their medical records. This quality improvement project demonstrates that the PIPHAS form is a useful tool to improve the speed, efficiency, and documentation of a thorough physical

  17. The association of physical examination abnormalities and carboxyhemoglobin concentrations in 21 dogs trapped in a kennel fire.

    Science.gov (United States)

    Ashbaugh, Elizabeth A; Mazzaferro, Elisa M; McKiernan, Brendan C; Drobatz, Kenneth J

    2012-06-01

    To evaluate physical examination findings and their association with carboxyhemoglobin (COHb) concentrations in 21 dogs that were exposed to smoke during a kennel fire. Twenty-one dogs were exposed to a kennel fire. Physical exam findings, presenting, and posttherapy COHb concentrations as well as therapeutic interventions were evaluated. COHb concentrations upon presentation were increased in all smoke inhalation exposed dogs. These dogs were compared to a small set of clinically normal staff-owned dogs who were not exposed to fire. Physical parameters significantly associated with higher COHb concentrations included lower body temperature, increased respiratory effort, abnormal respiratory auscultation, altered neurologic status, and length of hospital stay. Oxygen therapy resulted in a more rapid decline in COHb concentrations although 5 dogs still had mildly increased COHb concentrations 24-hour postadmission. This study describes the relationship of admitting clinical findings of dogs exposed to a kennel fire with their initial blood COHb concentrations. It also describes the resolution of increased COHb concentrations with use of oxygen therapy and hospitalization. Additionally, COHb concentrations for a control group of dogs was evaluated and compared to the dogs exposed to smoke inhalation. © Veterinary Emergency and Critical Care Society 2012.

  18. A Practical Concussion Physical Examination Toolbox.

    Science.gov (United States)

    Matuszak, Jason M; McVige, Jennifer; McPherson, Jacob; Willer, Barry; Leddy, John

    With heightened awareness of concussion, there is a need to assess and manage the concussed patient in a consistent manner. Unfortunately, concussion physical examination has not been standardized or supported by evidence. Important questions remain about the physical examination. Review of ClinicalKey, Cochrane, MEDLINE, and PubMed prior to July 2015 was performed using search terms, including concussion, mTBI, physical examination, mental status, cranial nerves, reflexes, cervical, vestibular, and oculomotor. The references of the pertinent articles were reviewed for other relevant sources. Clinical review. Level 3. The pertinent physical examination elements for concussion include evaluation of cranial nerves, manual muscle testing, and deep tendon reflexes; inspecting the head and neck for trauma or tenderness and cervical range of motion; Spurling maneuver; a static or dynamic balance assessment; screening ocular examination; and a mental status examination that includes orientation, immediate and delayed recall, concentration, mood, affect, insight, and judgment. Other examination elements to consider, based on signs, symptoms, or clinical suspicion, include testing of upper motor neurons, cervical strength and proprioception, coordination, pupillary reactivity, and visual acuity; examination of the jaw, temporomandibular joint, and thoracic spine; fundoscopic evaluation; orthostatic vital signs; assessment of dynamic visual acuity; and screening for depression, anxiety, substance abuse disorders, and preinjury psychiatric difficulties. Various elements of the physical examination, such as screening ocular examination, cervical musculoskeletal examination, static and/or dynamic balance assessment, and mental status examination, appear to have utility for evaluating concussion; however, data on validity are lacking.

  19. Usefulness of clinical data and rapid diagnostic tests to identify bacterial etiology in adult respiratory infections

    Directory of Open Access Journals (Sweden)

    Pilar Toledano-Sierra

    2015-01-01

    Full Text Available Respiratory tract infections are a common complaint and most of them, such as common cold and laryngitis, are viral in origin, so antibiotic use should be exceptional. However, there are other respiratory tract infections (sinusitis, pharyngitis, lower respiratory tract infections, and exacerbations of chronic obstructive pulmonary disease where a bacterial etiology is responsible for a non-negligible percentage, and antibiotics are often empirically indicated. The aim of the study is to identify the strength of the data obtained from the symptoms, physical examination and rapid diagnostic methods in respiratory infections in which antibiotic use is frequently proposed in order to improve diagnosis and influence the decision to prescribe these drugs. The review concludes that history, physical examination and rapid tests are useful to guide the need for antibiotic treatment in diseases such as acute sinusitis, acute pharyngitis, exacerbation of lower respiratory tract infection and chronic obstructive pulmonary disease. However, no isolated data is accurate enough by itself to confirm or rule out the need for antibiotics. Therefore, clinical prediction rules bring together history and physical examination, thereby improving the accuracy of the decision to indicate or not antibiotics.

  20. Exploration of the attitudes of nursing students to peer physical examination and physical examination of patients.

    Science.gov (United States)

    Wearn, Andy M; Bhoopatkar, Harsh; Mathew, Thomas K; Stewart, Lisa

    2013-08-01

    The use of peer physical examination (PPE) in early clinical skills has been studied amongst medical students. The majority of students are comfortable with using peer physical examination, when sensitive areas are excluded. Students' attitudes are related to their personal characteristics: gender, age, religious faith, and ethnicity. There is no data on nursing students' attitudes to peer physical examination. Identify and explore: Dual cohort, cross-sectional, anonymous survey. Three-year undergraduate nursing programme, skills centre and service clinical learning. All first and third year nursing students were asked to complete a modified Examining Fellow Students questionnaire at the end of 2008. The questionnaire asked students to indicate which of 12 body areas they would not be willing to examine/have examined by a peer of the same/opposite gender. This study also asked students which of the 12 body areas they felt uncomfortable examining on patients. The response rate was 76% (128/168). The students were predominantly female (93% female; 7% male). Most students were comfortable with examining non-sensitive body regions of peers (78.2%-100% willing) and patients (92.3-100% willing). Male gender was significantly associated with willingness to examine and be examined by peers (p=0.001); Asian students were significantly less willing to engage in peer physical examination with opposite gender (pexamining patients of either gender (pexamination shows similarities and differences to other studies. Student characteristics were not related to patient examination attitudes. Copyright © 2012 Elsevier Ltd. All rights reserved.

  1. Attentional Demands on Motor-Respiratory Coordination

    Science.gov (United States)

    Hessler, Eric E.; Amazeen, Polemnia G.

    2009-01-01

    Athletic performance requires the pacing of breathing with exercise, known as motor-respiratory coordination (MRC). In this study, we added cognitive and physical constraints while participants intentionally controlled their breathing locations during rhythmic arm movement. This is the first study to examine a cognitive constraint on MRC.…

  2. A Practical Concussion Physical Examination Toolbox

    Science.gov (United States)

    Matuszak, Jason M.; McVige, Jennifer; McPherson, Jacob; Willer, Barry; Leddy, John

    2016-01-01

    Context: With heightened awareness of concussion, there is a need to assess and manage the concussed patient in a consistent manner. Unfortunately, concussion physical examination has not been standardized or supported by evidence. Important questions remain about the physical examination. Evidence Acquisition: Review of ClinicalKey, Cochrane, MEDLINE, and PubMed prior to July 2015 was performed using search terms, including concussion, mTBI, physical examination, mental status, cranial nerves, reflexes, cervical, vestibular, and oculomotor. The references of the pertinent articles were reviewed for other relevant sources. Study Design: Clinical review. Level of Evidence: Level 3. Results: The pertinent physical examination elements for concussion include evaluation of cranial nerves, manual muscle testing, and deep tendon reflexes; inspecting the head and neck for trauma or tenderness and cervical range of motion; Spurling maneuver; a static or dynamic balance assessment; screening ocular examination; and a mental status examination that includes orientation, immediate and delayed recall, concentration, mood, affect, insight, and judgment. Other examination elements to consider, based on signs, symptoms, or clinical suspicion, include testing of upper motor neurons, cervical strength and proprioception, coordination, pupillary reactivity, and visual acuity; examination of the jaw, temporomandibular joint, and thoracic spine; fundoscopic evaluation; orthostatic vital signs; assessment of dynamic visual acuity; and screening for depression, anxiety, substance abuse disorders, and preinjury psychiatric difficulties. Conclusion: Various elements of the physical examination, such as screening ocular examination, cervical musculoskeletal examination, static and/or dynamic balance assessment, and mental status examination, appear to have utility for evaluating concussion; however, data on validity are lacking. PMID:27022058

  3. Efficacy of respiratory endoscopy on subjects requiring further detailed examinations after initial asbestos-related disease screening

    International Nuclear Information System (INIS)

    Fukuoka, Kazuya; Uesaka, Ayuko; Kuribayashi, Kozo

    2007-01-01

    We evaluated the efficacy of respiratory endoscopy on subjects requiring further detailed examinations as a result of initial asbestos-related disease screening. The subjects consisted of 132 participants who underwent asbestos-related disease screening in our hospital between July 2005 and March 2006. According to their history of screening, the participants were classified into the initial screening group and the second screening group. The former consisted of 76 participants without prior screening, while the latter consisted of 56 participants who were referred to our hospital for the detailed examinations as a result of initial screening undergone elsewhere. The participants were examined concerning their history of asbestos exposure, and then underwent chest X-ray followed by chest computed tomography (CT). Respiratory endoscopic examinations were mainly performed in participants with suspected chest malignancies. There were no significant differences in the distribution of age or gender between the two screening groups. In both screening groups, more than 70% of the participants had a history of occupational exposure to asbestos. Radiological abnormalities were observed in 110 (83%) of all participants. Asbestos-related diseases were detected in a total of 90 (68%) cases. The breakdown of the 90 cases by disease was as follows: 60 cases had pleural plaque, 13 pulmonary fibrosis, 5 lung cancer (LC), 4 benign asbestos pleurisy, 4 round atelectasis, 2 diffuse pleural thickening, and 2 malignant pleural mesothelioma (MPM). The disease detection rate of LC and MPM was 3.8% and 1.5%, respectively. Respiratory endoscopic examinations were performed in a total of 15 cases. The breakdown of the 15 cases by examination was as follows: bronchoscopy was performed in 6 cases, thoracoscopy including video-assisted thoracoscopic surgery (VATS) in 8, and mediastinoscopy in 4. Two cases with early LC were diagnosed by videothoracoscopic lung biopsy. A diagnosis of MPM was

  4. Student-patient communication during physical examination

    NARCIS (Netherlands)

    Cleland, Jennifer; de la Croix, Anne; Cotton, Philip; Coull, Sharon; Skelton, John

    BACKGROUND: Communication during the physical examination has been understudied. Explicit, evidence-based guidance is not available as to the most effective content or process of communication while performing physical examination, or indeed how to teach this to medical students. The objective of

  5. AAPT/NSTA High School Physics Examination.

    Science.gov (United States)

    Nelson, James

    1983-01-01

    Discusses development of the American Association of Physics Teachers and National Science Teachers Association (AAPT/NSTA) high school physics examination. Includes sample examination questions and distribution of topics: mechanics (30 percent), waves/optics/sound (20 percent), heat/kinetic theory (10 percent), electricity/magnetism (25 percent),…

  6. Respiratory adaptations in different types of sport.

    Science.gov (United States)

    Lazovic, B; Mazic, S; Suzic-Lazic, J; Djelic, M; Djordjevic-Saranovic, S; Durmic, T; Zikic, D; Zugic, V

    2015-06-01

    Recent studies demonstrated that current European Respiratory Society/American Thoracic Society spirometric reference equations, used in general population, may not be applicable in population of elite athletes. Althought it is well known that physical activity may affect lung volumes, the effect of sporting activity on pulmonary function testing indices was never examined. The aim of this study was to examine the differences in functional respiratory parameters in various types of sports by measuring lung volumes and to extend the existing factors as well as sport disciplines which affect respiratory function the most. A total of 1639 elite male athletes, aged 18-35 years were divided in 4 groups according to the predominant characteristics of training: skill, power, mixed and endurance athletes. They performed basic anthropometric measurements and spirometry. Groups were compared, and Pearson's simple correlation was performed to test the relation between anthropometric and spirometric characteristics of athletes. All anthropometric characteristics significantly differed among groups and correlate with respiratory parameters. The highest correlation was found for body height and weight. Sports participation is associated with respiratory adaptation, and the extent of adaptation depends on type of activity. Endurance sports athletes have higher lung volumes in comparison with skill, mixed and power group of sport.

  7. Seasonal variation in objectively measured physical activity, sedentary time, cardio-respiratory fitness and sleep duration among 8–11 year-old Danish children: a repeated-measures study

    DEFF Research Database (Denmark)

    Hjorth, Mads F.; Chaput, Jean-Philippe; Michaelsen, Kim

    2013-01-01

    BACKGROUND: Understanding fluctuations in lifestyle indicators is important to identify relevant time periods to intervene in order to promote a healthy lifestyle; however, objective assessment of multiple lifestyle indicators has never been done using a repeated-measures design. The primary aim...... was, therefore, to examine between-season and within-week variation in physical activity, sedentary behaviour, cardio-respiratory fitness and sleep duration among 8–11 year-old children. METHODS: A total of 1021 children from nine Danish schools were invited to participate and 834 accepted. Due...... to missing data, 730 children were included in the current analytical sample. An accelerometer was worn for 7 days and 8 nights during autumn, winter and spring, from which physical activity, sedentary time and sleep duration were measured. Cardio-respiratory fitness was assessed using a 10-min intermittent...

  8. CORRELATION OF PHYSICAL ACTIVITY LEVEL WITH BONE MINERAL DENSITY, CARDIO-RESPIRATORY FITNESS AND BODY COMPOSITION IN POST-MENOPAUSAL WOMEN

    Directory of Open Access Journals (Sweden)

    Niyati N Khona

    2017-09-01

    Full Text Available Background: Due to the hormonal changes in postmenopausal women they are prone for many complications like increased CVD risk factors, osteoporosis, obesity, mood swings and urinary incontinence. Physical inactivity in postmenopausal women leads to higher risk of developing CVD and osteoporosis. The objective was to find out the correlation of physical activity level with BMD, cardio-respiratory fitness and body composition in post-menopausal women Methods: 42 postmenopausal women were included. A detailed clinical evaluation with physical activity level (IPAQ-METS-mins/week, , BMD ( T-Scores, body composition (BMI, waist circumference, BIA & Skin fold calliper for fat %, cardio-respiratory fitness was measured by Balke protocol and VO2peak (ml/kg/min is estimated. Correlation of physical activity level with BMD, cardio-respiratory fitness and body composition were analysed using “Pearson’s product moment correlation co-efficient and Spearman’s rho.” Results: Spearman’s rank correlation rho for IPAQ with VO2 peak was 0.420,BMI was -0.388 and visceral fat was -0.384 indicating moderate positive correlation between IPAQ and cardio-respiratory fitness and weak negative correlation between IPAQ and BMI and visceral fat. Pearson’s product moment correlation coefficient of IPAQ with BMD was 0.147, body fat was -0.234 and waist circumference was -0.256 indicating no correlation. P value was significant for correlation of IPAQ with CRF (0.006, BMI (0.011 and Visceral fat (0.012. Conclusion: There is moderate positive correlation between IPAQ and cardio-respiratory fitness, weak negative correlation between IPAQ and BMI and visceral fat and no correlation between IPAQ and BMD, body fat and waist circumference

  9. Physical examination of swine.

    Science.gov (United States)

    Masters, B J; Hamilton, M; Masters, P G

    1992-07-01

    Swine may be examined to evaluate a disease state or a lowered economic performance or as a herd health consultation. As much of the examination as possible should be performed without handling the animal. A thorough history, evaluation of herd records, environmental examination, and herd examination should be performed prior to the evaluation of an individual animal. All necessary equipment should be available when starting the individual examination. The animals is then restrained and examined, and necessary samples are taken. Post-mortem examinations or slaughter house evaluations are a very frequent part of a health examination on swine. All samples taken should be in accordance with the standards of the laboratory that you use. You should work closely with the laboratory to obtain the best results. Physical examination of swine can be rewarding for the veterinarian as well as the producer. The most important aspect to remember is to have enough information and the proper equipment available to handle the animals for the minimal amount of time to gain the maximum benefits. Vietnamese pot-bellied pigs are similar to domestic swine in terms of their diseases and health but are dissimilar in management; pot-bellied pigs are frequently brought to the veterinarian for individual examinations. History is the most valuable part of the examination, followed by observation. Pot-bellied pigs prefer to be held securely with a hand under the chin and rump. The examination is conducted similarly to the examination of any companion animal. Chemical restraint often is necessary for sampling or minor surgical procedures. Owners should be consulted prior to the use of any restraint. This will help win their approval and confidence when working on their pets. While performing the physical examination, look at the pig's overall health as well as specific breed characteristics. Try to stay abreast of swine vaccination recommendations; you may be consulted in this regard. Most

  10. Cardio-respiratory capacity as an important biomarker of health

    Directory of Open Access Journals (Sweden)

    Jaroslav Novák

    2016-12-01

    Full Text Available Background: Cardio-respiratory capacity is an important factor in human health. It's quality depends on many objective factors (such as age and gender, but it can be influenced also by others (physical activity, nutrition. Low level of cardio-respiratory capacity significantly correlates with numerous health failures. Objective: Evaluation of the cardio-respiratory capacity in athletes enables a prediction of performance. In a non-sporting population a critically low level of cardio-respiratory capacity could be a warning signal of a high risk of diseases. The Spiroergometric examination needs very sophisticated technical equipment including O2-CO2 analyzer. The aim of the study was to examine the possibility of how to replace direct measurement of oxygen consumption by the method. Methods: 2 777 protocols from the data base of examinations performed in the period of 1994 till 2015 were used. Cardio-respiratory capacity in all examinations was evaluated according to maximal oxygen uptake VO2max, physical working capacity W170 and maximal performance on the cyclo-ergometer. Step-vice increased workload on cyclo-ergometer based on procedure used in International Biological Program was applied to obtain the characteristics of cardio-respiratory capacity of each subject (2 015 men and 762 women. Results: Correlation coefficients r and regression equations of cardio-respiratory capacity characteristics (W170, W170/kg, VO2max, VO2max/kg, Wmax, Wmax/kg were calculated. The highest correlation was found between VO2max and Wmax and between VO2max/kg and Wmax/kg, both in men and women (r = .89 in men and r = .85 in women for VO2max and Wmax. The most important regression equations are: (men VO2max = 0.0095 . Wmax + 0.54 (l/min (r = .89, VO2max/kg = 8.3 . Wmax/kg + 13 (ml/min/kg (r = .83; (women VO2max = 0.0083 . Wmax + 0.67 (l/min (r = .85, VO2max/kg = 8.0 . max/kg + 13 (ml/min/kg (r = .83. Conclusions: It was proved that VO2max and VO2max/kg values

  11. Oxygen therapy devices and portable ventilators for improved physical activity in daily life in patients with chronic respiratory disease.

    Science.gov (United States)

    Furlanetto, Karina Couto; Pitta, Fabio

    2017-02-01

    Patients with hypoxemia and chronic respiratory failure may need to use oxygen therapy to correct hypoxemia and to use ventilatory support to augment alveolar ventilation, reverse abnormalities in blood gases (in particular hypercapnia) and reduce the work of breathing. Areas covered: This narrative review provides an overview on the use of oxygen therapy devices or portable ventilators for improved physical activity in daily life (PADL) as well as discusses the issue of lower mobility in daily life among stable patients with chronic respiratory disease who present indication for long-term oxygen therapy (LTOT) or home-based noninvasive ventilation (NIV). A literature review of these concepts was performed by using all related search terms. Expert commentary: Technological advances led to the development of light and small oxygen therapy devices and portable ventilators which aim to facilitate patients' mobility and ambulation. However, the day-by-day dependence of a device may reduce mobility and partially impair patients' PADL. Nocturnal NIV implementation in hypercapnic patients seems promising to improve PADL. The magnitude of their equipment-related physical inactivity is underexplored up to this moment and more long-term randomized clinical trials and meta-analysis examining the effects of ambulatory oxygen and NIV on PADL are required.

  12. Interobserver reliability of physical examination of shoulder girdle

    NARCIS (Netherlands)

    Nomden, Jettie G.; Slagers, Anton J.; Bergman, Geert; Winters, Jan C.; Kropmans, Thomas J. B.; Dijkstra, Pieter U.

    The object of this study was to assess interobserver reliability in 23 tests concerning physical examination of the shoulder girdle. A physical therapist and a physical therapist/manual therapist independently performed a physical examination of the shoulder girdle in 91 patients with shoulder

  13. Examination of relationship between 30 second wingate test performance and spirometric respiratory functions in young adults

    Directory of Open Access Journals (Sweden)

    C Arslan

    2009-07-01

    Full Text Available Objective: This work has been planed to investigate whether the correlation between one of the important component of the sports performance spirometric respiratory function (SRF and 30 s Wingate Test (WT parameters of young adults who have different physical fitness level. Materials and Methods: This work included a total of 166 subjects those are 98 young boys (20.30±1.93 and 68 young girls (19.65±2.18. The subjects were divided into two groups namely regular exercises group (EG who make a regular exercises during 4.0±1.50 years and sedentary groups (SG. Both group’s subjects have similar age, height, weight and body mass index (BMI kg/m2. All the subjects were performed spirometric respiratory function test and WT power performance test. Statistical analyses were performed by SPSS computer program and the groups were compared to each other by using Independent Samples t test calculation and the correlation relation levels were calculated by using linear regression analysis. Results: In the view of physical peculiarities, it has not been found any difference between research groups that EG and SG (P>0.05. In the meaning of the measured spirometric respiratory functions and WT power performance, with the advantage of making regular sports, according to SG groups, the boys and girls EG groups showed differences (P<0.05. The correlational relationship between the spirometric and WT power parameters; it has been observed significant correlation between peak power (PP, mean power (MP, peak power/weight (PP/Wkg, mean power/weight (MP/Wkg form WT parameters and VC, FVC, FEV1, FEV1/FVC (% FEF25-75, PEF and MVV form respiration function (P<0.05 and P<0.001. On the other hand, it has not been found any significant correlation between WT anaerobic fatigue index (AFI % and respiratory functions (P<0.05. Conclusion: In this work, the tested spirometric respiratory functions have got an active role in the WT power parameters. It has been confirmed that

  14. 21 CFR 1210.12 - Physical examination of cows.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Physical examination of cows. 1210.12 Section 1210... FEDERAL IMPORT MILK ACT Inspection and Testing § 1210.12 Physical examination of cows. (a) Physical examination of any and all cows in herds producing milk or cream which is to be shipped or transported into...

  15. The Physical Examination as Ritual: Social Sciences and Embodiment in the Context of the Physical Examination.

    Science.gov (United States)

    Costanzo, Cari; Verghese, Abraham

    2018-05-01

    The privilege of examining a patient is a skill of value beyond its diagnostic utility. A thorough physical examination is an important ritual that benefits patients and physicians. The concept of embodiment helps one understand how illness and pain further define and shape the lived experiences of individuals in the context of their race, gender, sexuality, and socioeconomic status. Understanding ritual in medicine, including the placebo effects of such rituals, reaffirms the centrality of the physical examination to the process of building strong physician-patient relationships. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. The reach of Spanish-language YouTube videos on physical examinations made by undergraduate medical students.

    Science.gov (United States)

    Ramos-Rincón, José M; Belinchón-Romero, Isabel; Sánchez-Ferrer, Francisco; Torre, Guillermo Martínez-de la; Harris, Meggan; Sánchez-Fernández, Javier

    2017-01-01

    This study was conducted to evaluate the performance and reach of YouTube videos on physical examinations made by Spanish university students. We analyzed performance metrics for 4 videos on physical examinations in Spanish that were created by medical students at Miguel Hernández University (Elche, Spain) and are available on YouTube, on the following topics: the head and neck (7:30), the cardiovascular system (7:38), the respiratory system (13:54), and the abdomen (11:10). We used the Analytics application offered by the YouTube platform to analyze the reach of the videos from the upload date (February 17, 2015) to July 28, 2017 (2 years, 5 months, and 11 days). The total number of views, length of watch-time, and the mean view duration for the 4 videos were, respectively: 164,403 views (mean, 41,101 views; range, 12,389 to 94,573 views), 425,888 minutes (mean, 106,472 minutes; range, 37,889 to 172,840 minutes), and 2:56 minutes (range, 1:49 to 4:03 minutes). Mexico was the most frequent playback location, followed by Spain, Colombia, and Venezuela. Uruguay, Ecuador, Mexico, and Puerto Rico had the most views per 100,000 population. Spanish-language tutorials are an alternative tool for teaching physical examination skills to students whose first language is not English. The videos were especially popular in Uruguay, Ecuador, and Mexico.

  17. An examination of interventions to reduce respiratory health and injury hazards in homes of low-income families

    International Nuclear Information System (INIS)

    Dixon, Sherry L.; Fowler, Cecile; Harris, Judy; Moffat, Sally; Martinez, Yolanda; Walton, Heather; Ruiz, Bernice; Jacobs, David E.

    2009-01-01

    We evaluated whether combining asthma trigger reduction with housing structural repairs, device disbursement and education in low-income households with children would improve self-reported respiratory health and reduce housing-related respiratory health and injury hazards (convenience sample of n=67 homes with 63 asthmatic and 121 non-asthmatic children). At baseline, a visual assessment of the home environment and a structured occupant interview were used to examine 29 potential injury hazards and 7 potential respiratory health hazards. A home-specific intervention was designed to provide the children's parents or caretakers with the knowledge, skills, motivation, supplies, equipment, and minimum housing conditions necessary for a healthy and safe home. The enrolled households were primarily Hispanic and owned their homes. On average, 8 injury hazards were observed in the homes at baseline. Four months following intervention, the average declined to 2.2 hazards per home (p<0.001), with 97% of the parents reporting that their homes were safer following the interventions. An average of 3.3 respiratory health hazards were observed in the homes at baseline. Four months following intervention, the average declined to 0.9 hazards per home (p<0.001), with 96% of parents reporting that the respiratory health of their asthmatic children improved. A tailored healthy homes improvement package significantly improves self-reported respiratory health and safety, reduces respiratory health and injury hazards, and can be implemented in concert with a mobile clinical setting

  18. Cardiac Limited Ultrasound Examination Techniques to Augment the Bedside Cardiac Physical Examination.

    Science.gov (United States)

    Kimura, Bruce J; Shaw, David J; Amundson, Stan A; Phan, James N; Blanchard, Daniel G; DeMaria, Anthony N

    2015-09-01

    The current practice of physical diagnosis is dependent on physician skills and biases, inductive reasoning, and time efficiency. Although the clinical utility of echocardiography is well known, few data exist on how to integrate 2-dimensional screening "quick-look" ultrasound applications into a novel, modernized cardiac physical examination. We discuss the evidence basis behind ultrasound "signs" pertinent to the cardiovascular system and elemental in synthesis of bedside diagnoses and propose the application of a brief cardiac limited ultrasound examination based on these signs. An ultrasound-augmented cardiac physical examination can be taught in traditional medical education and has the potential to improve bedside diagnosis and patient care. © 2015 by the American Institute of Ultrasound in Medicine.

  19. The reach of Spanish-language YouTube videos on physical examinations made by undergraduate medical students

    Directory of Open Access Journals (Sweden)

    José M. Ramos-Rincón

    2017-12-01

    Full Text Available This study was conducted to evaluate the performance and reach of YouTube videos on physical examinations made by Spanish university students. We analyzed performance metrics for 4 videos on physical examinations in Spanish that were created by medical students at Miguel Hernández University (Elche, Spain and are available on YouTube, on the following topics: the head and neck (7:30, the cardiovascular system (7:38, the respiratory system (13:54, and the abdomen (11:10. We used the Analytics application offered by the YouTube platform to analyze the reach of the videos from the upload date (February 17, 2015 to July 28, 2017 (2 years, 5 months, and 11 days. The total number of views, length of watch-time, and the mean view duration for the 4 videos were, respectively: 164,403 views (mean, 41,101 views; range, 12,389 to 94,573 views, 425,888 minutes (mean, 106,472 minutes; range, 37,889 to 172,840 minutes, and 2:56 minutes (range, 1:49 to 4:03 minutes. Mexico was the most frequent playback location, followed by Spain, Colombia, and Venezuela. Uruguay, Ecuador, Mexico, and Puerto Rico had the most views per 100,000 population. Spanish-language tutorials are an alternative tool for teaching physical examination skills to students whose first language is not English. The videos were especially popular in Uruguay, Ecuador, and Mexico.

  20. The reach of Spanish-language YouTube videos on physical examinations made by undergraduate medical students

    Science.gov (United States)

    2017-01-01

    This study was conducted to evaluate the performance and reach of YouTube videos on physical examinations made by Spanish university students. We analyzed performance metrics for 4 videos on physical examinations in Spanish that were created by medical students at Miguel Hernández University (Elche, Spain) and are available on YouTube, on the following topics: the head and neck (7:30), the cardiovascular system (7:38), the respiratory system (13:54), and the abdomen (11:10). We used the Analytics application offered by the YouTube platform to analyze the reach of the videos from the upload date (February 17, 2015) to July 28, 2017 (2 years, 5 months, and 11 days). The total number of views, length of watch-time, and the mean view duration for the 4 videos were, respectively: 164,403 views (mean, 41,101 views; range, 12,389 to 94,573 views), 425,888 minutes (mean, 106,472 minutes; range, 37,889 to 172,840 minutes), and 2:56 minutes (range, 1:49 to 4:03 minutes). Mexico was the most frequent playback location, followed by Spain, Colombia, and Venezuela. Uruguay, Ecuador, Mexico, and Puerto Rico had the most views per 100,000 population. Spanish-language tutorials are an alternative tool for teaching physical examination skills to students whose first language is not English. The videos were especially popular in Uruguay, Ecuador, and Mexico. PMID:29278903

  1. Sports Potentials for Physical Fitness.

    Science.gov (United States)

    Clarke, H. Harrison, Ed.

    1978-01-01

    This report, one of a series on research into specific physical activities and their efficacy in improving and maintaining physical fitness, examines sport participation and the potential it has for developing muscular strength, muscular endurance, and circulatory-respiratory endurance. The activities consist primarily of the following twelve…

  2. Critical-thinking ability in respiratory care students and its correlation with age, educational background, and performance on national board examinations.

    Science.gov (United States)

    Wettstein, Richard B; Wilkins, Robert L; Gardner, Donna D; Restrepo, Ruben D

    2011-03-01

    Critical thinking is an important characteristic to develop in respiratory care students. We used the short-form Watson-Glaser Critical Thinking Appraisal instrument to measure critical-thinking ability in 55 senior respiratory care students in a baccalaureate respiratory care program. We calculated the Pearson correlation coefficient to assess the relationships between critical-thinking score, age, and student performance on the clinical-simulation component of the national respiratory care boards examination. We used chi-square analysis to assess the association between critical-thinking score and educational background. There was no significant relationship between critical-thinking score and age, or between critical-thinking score and student performance on the clinical-simulation component. There was a significant (P = .04) positive association between a strong science-course background and critical-thinking score, which might be useful in predicting a student's ability to perform in areas where critical thinking is of paramount importance, such as clinical competencies, and to guide candidate-selection for respiratory care programs.

  3. Physical activity, Cardio-Respiratory Fitness, and Metabolic Traits in Rural Mexican Tarahumara

    DEFF Research Database (Denmark)

    Christensen, Dirk Lund; Alcala-Sanchez, Imelda; Leal-Berumen, Irene

    2012-01-01

    Objectives: To study the association between physical activity energy expenditure (PAEE) and cardio-respiratory fitness (CRF) with key metabolic traits and anthropometric measures in the Tarahumara of Mexico. Methods: A cross-sectional study was carried out in five rural communities in Chihuahua...... suggests high levels of overweight and hypertension in the Tarahumara, and points to fitness and physical activity as potential intervention targets although findings should be confirmed in larger samples.......) to estimate CRF. Random blood glucose level and resting blood pressure (BP) were measured with standard anthropometrics. Results: Mean (SD) PAEE was 71.2 (30.3) kJ kg21 day21 and CRF was 36.6 (6.5) mlO2 min21 kg21. Mean (SD) glucose was 127.9 (32.4) mg/dl, with 3.3% having diabetes. Mean (SD) systolic...

  4. Respiratory mechanics and results of cytologic examination of bronchoalveolar lavage fluid in healthy adult alpacas.

    Science.gov (United States)

    Pacheco, Ana P; Bedenice, Daniela; Mazan, Melissa R; Hoffman, Andrew M

    2012-01-01

    To evaluate respiratory mechanical function and bronchoalveolar lavage (BAL) cytologic results in healthy alpacas. 16 client-owned adult alpacas. Measurements of pulmonary function were performed, including functional residual capacity (FRC) via helium dilution, respiratory system resistance via forced oscillatory technique (FOT), and assessment of breathing pattern by use of respiratory inductive plethysmography (RIP) in standing and sternally recumbent alpacas. Bronchoalveolar lavage was performed orotracheally during short-term anesthesia. Mean ± SD measurements of respiratory function were obtained in standing alpacas for FRC (3.19 ± 0.53 L), tidal volume (0.8 ± 0.13 L), and respiratory system resistance at 1 Hz (2.70 ± 0.88 cm H(2)O/L/s), 2 Hz (2.98 ± 0.70 cm H(2)O/L/s), 3 Hz (3.14 ± 0.77 cm H(2)O/L/s), 5 Hz (3.45 ± 0.91 cm H(2)O/L/s), and 7 Hz (3.84 ± 0.93 cm H(2)O/L/s). Mean phase angle, as a measurement of thoracoabdominal asynchrony, was 19.59 ± 10.06°, and mean difference between nasal and plethysmographic flow measurements was 0.18 ± 0.07 L/s. Tidal volume, peak inspiratory flow, and peak expiratory flow were significantly higher in sternally recumbent alpacas than in standing alpacas. Cytologic examination of BAL fluid revealed 58.52 ± 12.36% alveolar macrophages, 30.53 ± 13.78% lymphocytes, 10.95 ± 9.29% neutrophils, 0% mast cells, and several ciliated epithelial cells. Pulmonary function testing was tolerated well in nonsedated untrained alpacas. Bronchoalveolar lavage in alpacas yielded samples with adequate cellularity that had a greater abundance of neutrophils than has been reported in horses.

  5. Diagnosis of thyroid disease. Anamnesis and physical examination

    International Nuclear Information System (INIS)

    Freudenberg, L.S.

    2008-01-01

    Anamnesis and physical examination rank first in the diagnostic process of thyroid disease. They provide a basis for subsequent diagnostic procedures and treatment. This article focusses on personal, medical and familial history as well as physical examination of the neck and general clinical examination with respect to signs and symptoms of hypo- or hyperthyreoidism. In addition indications for fine-needle biopsy and biopsy technique are described. (orig.)

  6. Comparison of asbestos-associated respiratory disease by medical examination between shipyard retiree and workers of active service with asbestos exposure

    International Nuclear Information System (INIS)

    Ikeda, Tooru; Yoshida, Toshiaki; Fujisawa, Hiroyuki; Tanaka, Ayako; Ikeda, Hideki; Kawano, Hiroaki

    2009-01-01

    We examined 407 shipyard workers with asbestos exposure (406 men and one woman; mean age, 60.4 years) for asbestos-associated respiratory disease using the multi-slice chest CT in addition to the regular examinations. After the examination, workers with suspicion of malignancy by the multi-slice CT, other examinations including biopsy were performed to make the final diagnosis. We divided these people into two groups as follows; retiree (133 cases, 132 men and one woman; mean age, 65.9 years) and workers of shipyard active service (274 cases, all men, mean age, 57.6 years). We compared the incidence of asbestos-associated respiratory disease, age, incubation time and work period at asbestos exposure in these two groups. 97 of 133 (72.9%) retired workers and 94 of 274 (34.4%) active service had asbestos-associated respiratory disease as follows: pleural plaque without calcification, 25 cases (18.8%) (retired) and 35 (12.8%) (active service); pleural plaque with calcification, 65 (48.7%) and 51 (18.6%); diffuse pleural thickening, 0 (0%) and 0 (0%); asbestosis, 5 (3.8%) and 6 (2.2%); lung cancer, 1 case (0.8%) and 2 cases (0.7%) and malignant pleural mesothelioma 1 case (0.8%) and none (0%). The rate of workers with total asbestos-associated respiratory disease in the retired group was significantly higher than that in active service (P<0.01). Especially pleural plaque with calcification were detected more in shipyard retired workers than active service workers. The incidence of pleural plaque is related to age and incubation time but not to work period at asbestos exposure. (author)

  7. Evaluation of Hemodynamic Changes and Respiratory Physical Findings in Patients with Pulmonary Embolism

    Directory of Open Access Journals (Sweden)

    Masome Rabieepour

    2014-07-01

    Full Text Available Introduction: Pulmonary thromboembolism (PTE is a potentially fatal disease with nonspecific symptoms and signs. Patients with Pulmonary embolism often have dyspnea, chest pain, haemoptysis, tachycardia tachypnea and respiratory physical finding including hypoxia and decreased ETCO2. Daily patients with Pulmonary embolism are very few in hospital course and we aimed to determine clinical and paraclinical findings in hospital pulmonary embolism patients. Methods: we assessed in hospital course of 104 patients with pulmonary embolism with symptom (dyspnea, chest pain, and hemoptysis and signs (tachypnea, tachycardia, DVT signs, blood pressure and respiratory physical findings (PO2, ETCO2. Results: majority of patients had risk factor for PTE; the most common was cancer. 21.2% of patients had apparent DVT in Doppler sonography. Isolated dyspnea (38%, chest pain with and without hemoptysis (60% and syncope (2% were observed in patients. Mean duration of dyspnea resolution was 3.4 days. Mean duration of chest pain resolution was 1.76 days. Mean duration of hemoptysis resolution was 2 days. 64.4% of the patients were hypoxic and mean duration of hypoxic resolution was 2.63 days. Mean duration of tachycardia resolution was 2.37 days. No relation was observed between size of PTE and mortality or hypotension and PO2. Mean ETCO2 was 23±2 mmHg and 86.5% of patients had ETCO2 lower than 28. Mean duration of ETCO2 resolution was 3.6 days. Most common physical finding that resolved later than others was ETCO2. In 32.7% of patients, ETCO2 did not resolve.   Key words: Pulmonary thromboembolism; Tachycardia; Tachypnea; Hemoptysis; Hypoxic; ETCO2

  8. Physical fitness and mitochondrial respiratory capacity in horse skeletal muscle.

    Directory of Open Access Journals (Sweden)

    Dominique-Marie Votion

    Full Text Available BACKGROUND: Within the animal kingdom, horses are among the most powerful aerobic athletic mammals. Determination of muscle respiratory capacity and control improves our knowledge of mitochondrial physiology in horses and high aerobic performance in general. METHODOLOGY/PRINCIPAL FINDINGS: We applied high-resolution respirometry and multiple substrate-uncoupler-inhibitor titration protocols to study mitochondrial physiology in small (1.0-2.5 mg permeabilized muscle fibres sampled from triceps brachii of healthy horses. Oxidative phosphorylation (OXPHOS capacity (pmol O(2 • s(-1 • mg(-1 wet weight with combined Complex I and II (CI+II substrate supply (malate+glutamate+succinate increased from 77 ± 18 in overweight horses to 103 ± 18, 122 ± 15, and 129 ± 12 in untrained, trained and competitive horses (N = 3, 8, 16, and 5, respectively. Similar to human muscle mitochondria, equine OXPHOS capacity was limited by the phosphorylation system to 0.85 ± 0.10 (N = 32 of electron transfer capacity, independent of fitness level. In 15 trained horses, OXPHOS capacity increased from 119 ± 12 to 134 ± 37 when pyruvate was included in the CI+II substrate cocktail. Relative to this maximum OXPHOS capacity, Complex I (CI-linked OXPHOS capacities were only 50% with glutamate+malate, 64% with pyruvate+malate, and 68% with pyruvate+malate+glutamate, and ~78% with CII-linked succinate+rotenone. OXPHOS capacity with glutamate+malate increased with fitness relative to CI+II-supported ETS capacity from a flux control ratio of 0.38 to 0.40, 0.41 and 0.46 in overweight to competitive horses, whereas the CII/CI+II substrate control ratio remained constant at 0.70. Therefore, the apparent deficit of the CI- over CII-linked pathway capacity was reduced with physical fitness. CONCLUSIONS/SIGNIFICANCE: The scope of mitochondrial density-dependent OXPHOS capacity and the density-independent (qualitative increase of CI-linked respiratory capacity with increased

  9. Influence of patient symptoms and physical findings on general practitioners' treatment of respiratory tract infections: a direct observation study

    Directory of Open Access Journals (Sweden)

    Kochen Michael M

    2005-02-01

    Full Text Available Abstract Background The high rate of antibiotic prescriptions general practitioners (GPs make for respiratory tract infections (RTI are often explained by non-medical reasons e.g. an effort to meet patient expectations. Additionally, it is known that GPs to some extent believe in the necessity of antibiotic treatment in patients with assumed bacterial infections and therefore attempt to distinguish between viral and bacterial infections by history taking and physical examination. The influence of patient complaints and physical examination findings on GPs' prescribing behaviour was mostly investigated by indirect methods such as questionnaires. Methods Direct, structured observation during a winter "cough an cold period" in 30 (single handed general practices. All 273 patients with symptoms of RTI (age above 14, median 37 years, 51% female were included. Results The most frequent diagnoses were 'uncomplicated upper RTI/common cold' (43% followed by 'bronchitis' (26%. On average, 1.8 (95%-confidence interval (CI: 1.7–2.0 medicines per patient were prescribed (cough-and-cold preparations in 88% of the patients, antibiotics in 49%. Medical predictors of antibiotic prescribing were pathological findings in physical examination such as coated tonsils (odds ratio (OR 15.4, 95%-CI: 3.6–66.2 and unspecific symptoms like fatigue (OR 3.1, 95%-CI 1.4–6.7, fever (OR 2.2, 95%-CI: 1.1–4.5 and yellow sputum (OR 2.1, 95%-CI: 1.1–4.1. Analysed predictors explained 70% of the variance of antibiotic prescribing (R2 = 0,696. Efforts to reduce antibiotic prescribing, e.g. recommendations for self-medication, counselling on home remedies or delayed antibiotic prescribing were rare. Conclusions Patient complaints and pathological results in physical examination were strong predictors of antibiotic prescribing. Efforts to reduce antibiotic prescribing should account for GPs' beliefs in those (non evidence based predictors. The method of direct observation was

  10. Comparing Physical Examination With Sonographic Versions of the Same Examination Techniques for Splenomegaly.

    Science.gov (United States)

    Cessford, Tara; Meneilly, Graydon S; Arishenkoff, Shane; Eddy, Christopher; Chen, Luke Y C; Kim, Daniel J; Ma, Irene W Y

    2017-12-08

    To determine whether sonographic versions of physical examination techniques can accurately identify splenomegaly, Castell's method (Ann Intern Med 1967; 67:1265-1267), the sonographic Castell's method, spleen tip palpation, and the sonographic spleen tip technique were compared with reference measurements. Two clinicians trained in bedside sonography patients recruited from an urban hematology clinic. Each patient was examined for splenomegaly using conventional percussion and palpation techniques (Castell's method and spleen tip palpation, respectively), as well as the sonographic versions of these maneuvers (sonographic Castell's method and sonographic spleen tip technique). Results were compared with a reference standard based on professional sonographer measurements. The sonographic Castell's method had greater sensitivity (91.7% [95% confidence interval, 61.5% to 99.8%]) than the traditional Castell's method (83.3% [95% confidence interval, 51.6% to 97.9%]) but took longer to perform [mean ± SD, 28.8 ± 18.6 versus 18.8 ± 8.1 seconds; P = .01). Palpable and positive sonographic spleen tip results were both 100% specific, but the sonographic spleen tip method was more sensitive (58.3% [95% confidence interval, 27.7% to 84.8%] versus 33.3% [95% confidence interval, 9.9% to 65.1%]). Sonographic versions of traditional physical examination maneuvers have greater diagnostic accuracy than the physical examination maneuvers from which they are derived but may take longer to perform. We recommend a combination of traditional physical examination and sonographic techniques when evaluating for splenomegaly at the bedside. © 2017 by the American Institute of Ultrasound in Medicine.

  11. A survey on respiratory diseases of atomic bomb survivors using chest X-ray examination

    International Nuclear Information System (INIS)

    Sasaki, Hideo; Noma, Koji; Ito, Chikako; Mitsuyama, Toyofumi; Kamitsuna, Akimitsu; Nishimoto, Yukio; Katsuta, Shizutomo.

    1986-01-01

    From April 1981 through March 1986, 39,363 A-bomb survivors older than 50 years of age underwent chest X-ray examination. The incidence of abnormal findings was higher in men (28 %) than in women (13 %). The most common disease was old pulmonary tuberculosis in both men and women. The incidence of pulmonary fibrosis was remarkably high in survivors exposed directly to A-bomb radiation, when compared with controls. There was no data suggesting the relationship between the incidence of respiratory disease and exposure status such as the distance from ground zero. (Namekawa, K.)

  12. Physical examination is sufficient for the diagnosis of sprained ankles

    NARCIS (Netherlands)

    van Dijk, C. N.; Lim, L. S.; Bossuyt, P. M.; Marti, R. K.

    1996-01-01

    We studied the merits of physical examination after inversion injury of the ankle in 160 consecutive patients. They had an explanatory operation if they had a positive arthrogram and/or positive signs on a delayed physical examination. To determine the interobserver variation in delayed physical

  13. Sensitivity of physical examination versus arthroscopy in diagnosing subscapularis tendon injury.

    Science.gov (United States)

    Faruqui, Sami; Wijdicks, Coen; Foad, Abdullah

    2014-01-01

    The purpose of this study was to examine the accuracy of physical examination in the detection of subscapularis tendon tears and compare it with the gold standard of arthroscopy to determine whether clinical examination can reliably predict the presence of subscapularis tendon tears. This was a retrospective analysis of 52 patients (52 shoulders) who underwent arthroscopic subscapularis tendon repairs between September 2008 and April 2012. Positive findings on any combination of the belly press, lift-off, and bear hug tests constituted a positive physical examination result. There was a positive finding on physical examination in 42 of 52 patients. The sensitivity of the physical examination as a whole was 81%. The literature has shown that the belly press, bear hug, and lift-off tests are specific to the subscapularis tendon. To the authors’ knowledge, this is the first study to evaluate the sensitivity of these 3 separate clinical tests as a composite. Knowledge regarding the sensitivity of the subscapularis-specific physical examination as a composite can lead practitioners to implement all 3 components, even when 1 test has a negative finding, thus promoting a more thorough physical examination. Because unrepaired subscapularis tendon tears can result in poor outcomes in the repair of other rotator cuff tendons, a complete physical examination would be beneficial to patients with shoulder pathology. The authors conclude that physical examination, when performed consistently by an experienced practitioner, can reliably predict the presence of subscapularis tendon tears.

  14. Preseason physical examination for the prevention of sports injuries.

    Science.gov (United States)

    McKeag, D B

    1985-01-01

    The importance of the preseason physical examination and preparticipation evaluation of sports candidates is highlighted because it constitutes one of the few occasions in which the physician can actively prevent sports injuries from occurring. As exercise participation continues to increase on a world-wide basis, an understanding of the goals and objectives of such a pre-exercise evaluation are important. The need is not for a standard evaluation form, but for a consistent understanding of adjusting the evaluation to the age of the candidate, the type of sport to be engaged in and the anticipated level of competition. Essentials of any evaluation are musculoskeletal, cardiovascular and psychological examinations. Examinations should have clearly defined objectives, and factors determining the type of evaluation include: prospective athlete; contemplated exercise programme; and motivation. Different types of implementation are individual examinations, locker room technique and the station technique, each with advantages and disadvantages. A pre-exercise evaluation should always occur before any anticipated change in level of school or competition with an interval or intercurrent history and physical examinations occurring at regular intervals. It is important that examinations take place before the commencement of a sports season so previous injuries and problems can be dealt with; timing is vital. Contents of a pre-exercise physical examination should include history, a physical examination, laboratory testing and additional specific screening evaluations. Finally, assessment of the pre-exercise evaluation and injury prediction will aid physicians in preparticipation evaluations.

  15. [Physical therapy performance in respiratory and motor involvement during postoperative in children submitted to abdominal surgeries].

    Science.gov (United States)

    Santo, Caroline C; Gonçalves, Marcela T; Piccolo, Mariana M; Lima, Simone; Rosa, George J da; Paulin, Elaine; Schivinski, Camila S

    2011-01-01

    to verify the physiotherapy performance in the respiratory and motor affections during postoperative period in pediatric patients undergoing abdominal surgery. was a literature review of articles published in the databases Lilacs, Medline and SciELO in the period 1983 to 2010 as well as books, papers presented at scientific meetings and journals of the area, who approached the post-therapy of abdominal surgery in children. The keywords used were: abdominal surgery, children and physiotherapy. 28 articles, one book chapter and one dissertation had been selected that examined the question and proposed that contained all, or at least two of the descriptors listed. Most of the material included covers the incidence of respiratory complications after surgery for pediatric abdominal surgery due to immaturity of the respiratory system of this population, abdominal manipulation of surgical period, the prolonged time in bed, pain at the incision site and waste anesthetic. Some authors also discuss the musculoskeletal and connective tissue arising from the inaction and delay of psychomotor development consequent to periods of hospitalization in early childhood, taking on the role of physiotherapy to prevent motor and respiratory involvement. there are few publications addressing this topic, but the positive aspects of physiotherapy have been described, especially in relation to the prevention of respiratory complications and motor, recognized the constraints and consequences of hospitalizations and surgeries cause in children.

  16. [Effect of physical properties of respiratory gas on pneumotachographic measurement of ventilation in newborn infants].

    Science.gov (United States)

    Foitzik, B; Schmalisch, G; Wauer, R R

    1994-04-01

    The measurement of ventilation in neonates has a number of specific characteristics; in contrast to lung function testing in adults, the inspiratory gas for neonates is often conditioned. In pneumotachographs (PNT) based on Hagen-Poiseuille's law, changes in physical characteristics of respiratory gas (temperature, humidity, pressure and oxygen fraction [FiO2]) produce a volume change as calculated with the ideal gas equation p*V/T = const; in addition, the viscosity of the gas is also changed, thus leading to measuring errors. In clinical practice, the effect of viscosity on volume measurement is often ignored. The accuracy of these empirical laws was investigated in a size 0 Fleisch-PNT using a flow-through technique and variously processed respiratory gas. Spontaneous breathing was simulated with the aid of a calibration syringe (20 ml) and a rate of 30 min-1. The largest change in viscosity (11.6% at 22 degrees C and dry gas) is found with an increase in FiO2 (21...100%). A rise in temperature from 24 to 35 degrees C (dry air) produced an increase in viscosity of 5.2%. An increase of humidity (0...90%, 35 degrees C) decreased the viscosity by 3%. A partial compensation of these viscosity errors is thus possible. Pressure change (0...50 mbar, under ambient conditions) caused no measurable viscosity error. With the exception of temperature, the measurements have shown good agreement between the measured volume measuring errors and those calculated from viscosity changes. If the respiratory gas differs from ambient air (e.g. elevated FiO2) or if the PNT is calibrated under BTPS conditions, changes in viscosity must not be neglected when performing accurate ventilation measurements. On the basis of the well-known physical laws of Dalton, Thiesen and Sutherland, a numerical correction of adequate accuracy is possible.

  17. [Diagnosis. History and physical examination].

    Science.gov (United States)

    Pérez Martín, Álvaro

    2014-01-01

    Family physicians play a key role in the diagnosis and management of patients with osteoarthritis. Diagnosis is mainly clinical and radiological. A complete history should be taken with meticulous physical examination of the joints. The history-taking should aim to detect risk factors and compatible clinical symptoms. Pain characteristics should be identified, distinguishing between mechanical and inflammatory pain, and an exhaustive examination of the joints should be performed, with evaluation of the presence of pain, deformity, mobility restrictions (both active and passive), crepitus, joint effusion, and inflammation. A differential diagnosis should be made with all diseases that affect the joints and/or produce joint stiffness. Copyright © 2014 Elsevier España, S.L. All rights reserved.

  18. Evolution of physics examining 1940-2000 at Cambridge

    Science.gov (United States)

    Roberts, A.; Brown, L. M.

    2001-07-01

    Much controversy exists about the supposed changing examination standards. Emphasis has been placed on the standards of GCSE and A-level examinations. However, many large employers recruit graduates, and so university examination standards also deserve attention. Here, Cambridge University Part II (third year undergraduate) examinations in Physics are studied since 1940. Trends in prescriptiveness, choice of questions, and other variables were found.

  19. A speculated cause of respiratory inhibition in infants.

    Science.gov (United States)

    Minowa, Hideki; Arai, Ikuyo; Yasuhara, Hajime; Ebisu, Reiko; Ohgitani, Ayako

    2018-10-01

    In our previous studies, we documented that threatened premature labor and asymmetrical intrauterine growth restriction were risk factors for respiratory inhibition. The goal of this study was to determine the cause of respiratory inhibition by considering perinatal risk factors. We examined 1497 infants with a gestational age of 36 weeks or greater. All infants were monitored using pulse oximetry and examined via cranial sonography. Respiratory inhibition was defined as severe hypoxemia caused by respiratory inhibition immediately after crying or gastroesophageal reflux or as a respiratory pause during feeding. We examined the relationships between respiratory inhibition and perinatal factors and speculated on the cause of respiratory inhibition. The median gestational age, birth weight, Apgar score at 1 min, and Apgar score at 5 min of the subjects were 38.9 weeks, 2930 g, 8.0 points, and 9.0 points, respectively. Respiratory inhibition was observed in 422 infants. Lateral ventricle enlargement and increased echogenicity in the ganglionic eminence were observed in 417 and 516 infants, respectively. Respiratory inhibition was significantly correlated with shorter gestational periods, twin pregnancies, lateral ventricle enlargement, and increased echogenicity in the ganglionic eminence. We speculate that umbilical cord compression is a major cause of respiratory inhibition.

  20. Respiratory Problems Associated with Surfing in Coastal Waters.

    Science.gov (United States)

    O'Halloran, Chris; Silver, Mary W; Lahiff, Maureen; Colford, John

    2017-03-01

    A pilot project was conducted to examine the health status and possible adverse health effects associated with seawater exposure (microbial water-quality indicators and phytoplankton abundance and their toxins) of surfers in Monterey Bay, Central California coastal waters. Forty-eight surfers enrolled in the study and completed an initial health background survey and weekly health surveys online using Survey Monkey. Descriptive statistics and generalized estimating equation, a regression technique, were used to identify longitudinal and correlated results. The surfers were predominately Caucasian, male, and physically active. They surfed approximately 4 h a week. Their average age was 34 years. The data indicated that the surfers were generally "healthy," with a low prevalence of diabetes, high cholesterol, and hypertension. Their most common health problems were allergies and asthma. During the study, 10% of the surfers reported gastrointestinal symptoms and 29% reported upper respiratory symptoms. This study suggests surfers were significantly more likely to report upper respiratory symptoms when they had a history of allergies, housemates with upper respiratory symptoms, and/or a history of previous adverse health symptoms while surfing during a "red tide" (an event often associated with the presence of phytoplankton toxins). Additionally, female surfers reported upper respiratory symptoms more than males.

  1. A 15-Month-Old Boy With Respiratory Distress and Parapharyngeal Abscess: A Case Report

    Directory of Open Access Journals (Sweden)

    Behdad Gharib

    2017-01-01

    Full Text Available Parapharyngeal abscess is a life-threatening disease. Upper respiratory tract infection is the main cause in children. We present a 15-month-old boy admitted to the emergency ward with the chief complaint of difficulty in breathing caused by parapharyngealabscess. His condition deteriorated gradually, and he transferred to the operation theater quickly for abscess drainage and because of the difficulty in orotracheal intubation; a tracheostomy was performed. His respiratory condition deteriorated 2 days after PICU admission, and the medical team noticed an unexplainable respiratory distress. A chest x ray obtained and showed a right side pneumothorax and subcutaneous emphysema around theneck area. The case presented here, had not been diagnosed at the first examination; however, there were enough clinical clues (such as respiratory distress, drooling, torticollis, bulging of theneck, previous viral respiratory infection, possible pharyngeal trauma. The story of this case reminds us the importance of the precise physical exam and history taking which could be life-saving.

  2. Bias in the physical examination of patients with lumbar radiculopathy

    Directory of Open Access Journals (Sweden)

    Katz Jeffrey N

    2010-11-01

    Full Text Available Abstract Background No prior studies have examined systematic bias in the musculoskeletal physical examination. The objective of this study was to assess the effects of bias due to prior knowledge of lumbar spine magnetic resonance imaging findings (MRI on perceived diagnostic accuracy of the physical examination for lumbar radiculopathy. Methods This was a cross-sectional comparison of the performance characteristics of the physical examination with blinding to MRI results (the 'independent group' with performance in the situation where the physical examination was not blinded to MRI results (the 'non-independent group'. The reference standard was the final diagnostic impression of nerve root impingement by the examining physician. Subjects were recruited from a hospital-based outpatient specialty spine clinic. All adults age 18 and older presenting with lower extremity radiating pain of duration ≤ 12 weeks were evaluated for participation. 154 consecutively recruited subjects with lumbar disk herniation confirmed by lumbar spine MRI were included in this study. Sensitivities and specificities with 95% confidence intervals were calculated in the independent and non-independent groups for the four components of the radiculopathy examination: 1 provocative testing, 2 motor strength testing, 3 pinprick sensory testing, and 4 deep tendon reflex testing. Results The perceived sensitivity of sensory testing was higher with prior knowledge of MRI results (20% vs. 36%; p = 0.05. Sensitivities and specificities for exam components otherwise showed no statistically significant differences between groups. Conclusions Prior knowledge of lumbar MRI results may introduce bias into the pinprick sensory testing component of the physical examination for lumbar radiculopathy. No statistically significant effect of bias was seen for other components of the physical examination. The effect of bias due to prior knowledge of lumbar MRI results should be considered

  3. Bias in the physical examination of patients with lumbar radiculopathy

    Science.gov (United States)

    2010-01-01

    Background No prior studies have examined systematic bias in the musculoskeletal physical examination. The objective of this study was to assess the effects of bias due to prior knowledge of lumbar spine magnetic resonance imaging findings (MRI) on perceived diagnostic accuracy of the physical examination for lumbar radiculopathy. Methods This was a cross-sectional comparison of the performance characteristics of the physical examination with blinding to MRI results (the 'independent group') with performance in the situation where the physical examination was not blinded to MRI results (the 'non-independent group'). The reference standard was the final diagnostic impression of nerve root impingement by the examining physician. Subjects were recruited from a hospital-based outpatient specialty spine clinic. All adults age 18 and older presenting with lower extremity radiating pain of duration ≤ 12 weeks were evaluated for participation. 154 consecutively recruited subjects with lumbar disk herniation confirmed by lumbar spine MRI were included in this study. Sensitivities and specificities with 95% confidence intervals were calculated in the independent and non-independent groups for the four components of the radiculopathy examination: 1) provocative testing, 2) motor strength testing, 3) pinprick sensory testing, and 4) deep tendon reflex testing. Results The perceived sensitivity of sensory testing was higher with prior knowledge of MRI results (20% vs. 36%; p = 0.05). Sensitivities and specificities for exam components otherwise showed no statistically significant differences between groups. Conclusions Prior knowledge of lumbar MRI results may introduce bias into the pinprick sensory testing component of the physical examination for lumbar radiculopathy. No statistically significant effect of bias was seen for other components of the physical examination. The effect of bias due to prior knowledge of lumbar MRI results should be considered when an isolated

  4. The value of physical examination in mental health nursing.

    Science.gov (United States)

    Martin, Carolyn T

    2016-03-01

    This article explores the use of a physical examination assignment in a mental health general nursing clinical placement course that addresses the poor physical health of people with mental illness and the barriers traditionally impeding health care provision for this population. A descriptive qualitative approach utilizes inductive content analysis to investigate 145 student survey responses. The assignment assists student nurses in understanding that physical and mental well-being are intrinsically linked. Students report increased comfort performing a physical examination on patients with mental illness post assignment. Students' initial bias towards this population was minimized post the clinical assignment. Poor physical health is common among people with mental health problems. Many view the provision of care as a major public health issue. Nurses are the front line caregivers of mental health service consumers and are well positioned to assess their physical needs. Their assessment may be the first step in recognizing health care issues in this population. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Prevalence of Occupational Asthma and Respiratory Symptoms in Foundry Workers

    Directory of Open Access Journals (Sweden)

    Servet Kayhan

    2013-01-01

    Full Text Available This cross-sectional study was conducted in a foundry factory to assess the prevalence of respiratory symptoms and occupational asthma in foundry workers. Physical examination, spirometric evaluation, chest radiograph, and a questionnaire related to respiratory symptoms were performed. Monitoring of peak expiratory flow rates, spirometric reversibility test, and high-resolution computed tomographies were performed for the participants having respiratory symptoms and/or impaired respiratory function test. A total of 347 participants including 286 workers from production department and 61 subjects who worked in nonproduction departments were enrolled in this study. It is found that phlegm (n: 71, 20.46% and cough (n: 52, 14.98% were the most frequent symptoms. The other symptoms were breathlessness (n: 28, 8.06%, chest tightness (n: 14, 4.03%, and wheezing (n: 7, 2.01% . The prevalence of occupational asthma was found to be more frequent among the subjects who worked in the production department (n: 48, 16.78% than the other persons who worked in the nonproduction department (n: 3, 4.91% by chi-square test (P: 0.001. To prevent hazardous respiratory effects of the foundry production, an early diagnosis of occupational asthma is very important. Cessation of cigarette smoking and using of protective masks during the working time should be encouraged.

  6. Physical activity for health: examining similarities and differences ...

    African Journals Online (AJOL)

    In the face of a rising diabetes epidemic, a target population for prevention programme is the children of patients with type 2 diabetes. This study examined physical activity of patients with type 2 diabetes and that of their adult children, and characterized the factors associated with physical inactivity among the participants.

  7. Examining issues of underrepresented minority students in introductory physics

    Science.gov (United States)

    Watkins, Jessica Ellen

    In this dissertation we examine several issues related to the retention of under-represented minority students in physics and science. In the first section, we show that in calculus-based introductory physics courses, the gender gap on the FCI is diminished through the use of interactive techniques, but in lower-level introductory courses, the gap persists, similar to reports published at other institutions. We find that under-represented racial minorities perform similar to their peers with comparable academic preparation on conceptual surveys, but their average exam grades and course grades are lower. We also examine student persistence in science majors; finding a significant relationship between pedagogy in an introductory physics course and persistence in science. In the second section, we look at student end-of-semester evaluations and find that female students rate interactive teaching methods a full point lower than their male peers. Looking more deeply at student interview data, we find that female students report more social issues related to the discussions in class and both male and female students cite feeling pressure to obtain the correct answer to clicker questions. Finally, we take a look an often-cited claim for gender differences in STEM participation: cognitive differences explain achievement differences in physics. We examine specifically the role of mental rotations in physics achievement and problem-solving, viewing mental rotations as a tool that students can use on physics problems. We first look at student survey results for lower-level introductory students, finding a low, but significant correlation between performance on a mental rotations test and performance in introductory physics courses. In contrast, we did not find a significant relationship for students in the upper-level introductory course. We also examine student problem-solving interviews to investigate the role of mental rotations on introductory problems.

  8. Physical Examination for the Academic Psychiatrist: Primer and Common Clinical Scenarios.

    Science.gov (United States)

    Azzam, Pierre N; Gopalan, Priya; Brown, Jennifer R; Aquino, Patrick R

    2016-04-01

    As clinical psychiatry has evolved to mirror the patient care model followed in other medical specialties, psychiatrists are called upon increasingly to utilize general medical skills in routine practice. Psychiatrists who practice in academic settings are often required to generate broad differential diagnoses that include medical and neurologic conditions and, as a result, benefit from incorporating physical examination into their psychiatric assessments. Physical examination allows psychiatrists to follow and to teach patient-informed clinical practices and comprehensive treatment approaches. In this commentary, the authors encourage routine use of a targeted physical examination and outline common scenarios in which physical examination would be useful for the academic psychiatrist: delirium, toxidromes, and unexplained medical conditions (e.g., somatic symptom disorders).

  9. Student performance of the general physical examination in internal medicine: an observational study

    Science.gov (United States)

    2014-01-01

    Background Many practicing physicians lack skills in physical examination. It is not known whether physical examination skills already show deficiencies after an early phase of clinical training. At the end of the internal medicine clerkship students are expected to be able to perform a general physical examination in every new patient encounter. In a previous study, the basic physical examination items that should standardly be performed were set by consensus. The aim of the current observational study was to assess whether medical students were able to correctly perform a general physical examination regarding completeness as well as technique at the end of the clerkship internal medicine. Methods One hundred students who had just finished their clerkship internal medicine were asked to perform a general physical examination on a standardized patient as they had learned during the clerkship. They were recorded on camera. Frequency of performance of each component of the physical examination was counted. Adequacy of performance was determined as either correct or incorrect or not assessable using a checklist of short descriptions of each physical examination component. A reliability analysis was performed by calculation of the intra class correlation coefficient for total scores of five physical examinations rated by three trained physicians and for their agreement on performance of all items. Results Approximately 40% of the agreed standard physical examination items were not performed by the students. Students put the most emphasis on examination of general parameters, heart, lungs and abdomen. Many components of the physical examination were not performed as was taught during precourses. Intra-class correlation was high for total scores of the physical examinations 0.91 (p internal medicine clerkship. Possible causes and suggestions for improvement are discussed. PMID:24712683

  10. DiapHRaGM: A mnemonic to describe the work of breathing in patients with respiratory failure.

    Directory of Open Access Journals (Sweden)

    Aiman Tulaimat

    Full Text Available The assessment of the work of breathing in the definitions of respiratory failure is vague and variable.Identify a parsimonious set of signs to describe the work of breathing in hypoxemic, acutely ill patients.We examined consecutive medical ICU patients receiving oxygen with a mask, non-invasive ventilation, or T-piece. A physician inspected each patient for 10 seconds, rated the level of respiratory distress, and then examined the patient for vital signs and 17 other physical signs. We used the rating of distress as a surrogate for measuring the work of breathing, constructed three multivariate models to identify the one with the smallest number of signs and largest explained variance, and validated it with bootstrap analysis.We performed 402 observations on 240 patients. Respiratory distress was absent in 78, mild in 157, moderate in 107, and severe in 60. Respiratory rate, hypoxia, heart rate, and frequency of most signs increased as distress increased. Respiratory rate and hypoxia explained 43% of the variance in respiratory distress. Diaphoresis, gasping, and contraction of the sternomastoid explained an additional 28%. Heart rate, blood pressure, alertness, agitation, body posture, nasal flaring, audible breathing, cyanosis, tracheal tug, retractions, paradox, scalene or abdominal muscles contraction did not increase the explained variance in respiratory distress.Most of the variance is respiratory distress can be explained by five signs summarized by the mnemonic DiapHRaGM (diaphoresis, hypoxia, respiratory rate, gasping, accessory muscle. This set of signs may allow for efficient, standardized assessments of the work of breathing of hypoxic patients.

  11. Air ions and respiratory function outcomes: a comprehensive review

    Science.gov (United States)

    2013-01-01

    Background From a mechanistic or physical perspective there is no basis to suspect that electric charges on clusters of air molecules (air ions) would have beneficial or deleterious effects on respiratory function. Yet, there is a large lay and scientific literature spanning 80 years that asserts exposure to air ions affects the respiratory system and has other biological effects. Aims This review evaluates the scientific evidence in published human experimental studies regarding the effects of exposure to air ions on respiratory performance and symptoms. Methods We identified 23 studies (published 1933–1993) that met our inclusion criteria. Relevant data pertaining to study population characteristics, study design, experimental methods, statistical techniques, and study results were assessed. Where relevant, random effects meta-analysis models were utilized to quantify similar exposure and outcome groupings. Results The included studies examined the therapeutic benefits of exposure to negative air ions on respiratory outcomes, such as ventilatory function and asthmatic symptoms. Study specific sample sizes ranged between 7 and 23, and studies varied considerably by subject characteristics (e.g., infants with asthma, adults with emphysema), experimental method, outcomes measured (e.g., subjective symptoms, sensitivity, clinical pulmonary function), analytical design, and statistical reporting. Conclusions Despite numerous experimental and analytical differences across studies, the literature does not clearly support a beneficial role in exposure to negative air ions and respiratory function or asthmatic symptom alleviation. Further, collectively, the human experimental studies do not indicate a significant detrimental effect of exposure to positive air ions on respiratory measures. Exposure to negative or positive air ions does not appear to play an appreciable role in respiratory function. PMID:24016271

  12. Dermatological and respiratory problems in migrant construction workers of Udupi, Karnataka.

    Science.gov (United States)

    Banerjee, Mayuri; Kamath, Ramachandra; Tiwari, Rajnarayan R; Nair, Narayana Pillai Sreekumaran

    2015-01-01

    India being a developing country has tremendous demand of physical infrastructure and construction work as a result there is a raising demand of construction workers. Workers in construction industry are mainly migratory and employed on contract or subcontract basis. These workers face temporary relationship between employer and employee, uncertainty in working hours, contracting and subcontracting system, lack of basic continuous employment, lack basic amenities, and inadequacy in welfare schemes. To estimate the prevalence of respiratory and dermatological symptoms among migratory construction workers. This cross-sectional study was conducted in Manipal, Karnataka, among 340 male migratory construction workers. A standard modified questionnaire was used as a tool by the interviewer and the physical examination of the workers was done by a physician. The statistical analysis was done using Statistical Package for the Social Sciences (SPSS) version 15.0. Eighty percent of the workers belong to the age group of 18-30 years. The mean age of the workers was 26 ± 8.2 years. Most (43.8%) of the workers are from West Bengal followed by those from Bihar and Jharkhand. The rates of prevalence of respiratory and dermatological symptoms were 33.2% and 36.2%, respectively. The migrant construction workers suffer from a high proportion of respiratory and dermatological problems.

  13. Daytime napping and increased risk of incident respiratory diseases: symptom, marker, or risk factor?

    Science.gov (United States)

    Leng, Yue; Wainwright, Nick W J; Cappuccio, Francesco P; Surtees, Paul G; Hayat, Shabina; Luben, Robert; Brayne, Carol; Khaw, Kay-Tee

    2016-07-01

    We have identified a strong association between daytime napping and increased mortality risk from respiratory diseases, but little is known about the relationship between daytime napping and respiratory morbidity. Data were drawn from the European Prospective Investigation into Cancer and Nutrition-Norfolk cohort. Participants reported napping habits during 1998-2000 and were followed up for respiratory disease hospital admissions until March 2009. Cox proportional hazards regression was used to examine the association between daytime napping and respiratory disease incidence risk. The study sample included 10,978 men and women with a mean age of 61.9 years, and a total of 946 incident respiratory disease cases were recorded. After adjustment for age, sex, social class, education, marital status, employment status, nightshift work, body mass index, physical activity, smoking, alcohol intake, self-reported general health, hypnotic drug use, habitual sleep duration, and preexisting health conditions, daytime napping was associated with an increase in the overall respiratory disease incidence risk (hazard ratio (HR) = 1.32, 95% confidence interval (CI) 1.15, 1.52 for napping respiratory diseases, especially for the risk of chronic lower respiratory diseases (HR = 1.52, 95% CI: 1.18, 1.96 for napping respiratory disease incidence risk. Further studies are required to confirm these findings and help understand potential mechanisms. Copyright © 2016 The Author(s). Published by Elsevier B.V. All rights reserved.

  14. The value of the physical examination in clinical practice: an international survey.

    Science.gov (United States)

    Elder, Andrew T; McManus, I Chris; Patrick, Alan; Nair, Kichu; Vaughan, Louella; Dacre, Jane

    2017-12-01

    A structured online survey was used to establish the views of 2,684 practising clinicians of all ages in multiple countries about the value of the physical examination in the contemporary practice of internal medicine. 70% felt that physical examination was 'almost always valuable' in acute general medical referrals. 66% of trainees felt that they were never observed by a consultant when undertaking physical examination and 31% that consultants never demonstrated their use of the physical examination to them. Auscultation for pulmonary wheezes and crackles were the two signs most likely to be rated as frequently used and useful, with the character of the jugular venous waveform most likely to be rated as -infrequently used and not useful. Physicians in contemporary hospital general medical practice continue to value the contribution of the physical examination to assessment of outpatients and inpatients, but, in the opinion of trainees, teaching and demonstration could be improved. © Royal College of Physicians 2017. All rights reserved.

  15. The Clinical anatomy of the physical examination of the abdomen: A comprehensive review.

    Science.gov (United States)

    Bilal, Muhammad; Voin, Vlad; Topale, Nitsa; Iwanaga, Joe; Loukas, Marios; Tubbs, R Shane

    2017-04-01

    Physical examination of the abdomen is an essential skill. Knowledge of its clinical anatomy and application is vital for making diagnoses. Misinterpretation of anatomy during examination can have serious consequences. This review addresses understanding of the anatomy, methodology, and complications of abdominal physical examination. It includes particular reference to modern technology and investigations. Physical examination is performed for diagnostic purposes. However, the art of physical examination is declining as more and more clinicians rely on newer technology. This can have regrettable consequences: negligence, waste of time and resources, and deterioration of clinical skills. With a sound knowledge of clinical anatomy, and realization of the importance of physical examination of the abdomen, clinician, and patients alike can benefit. Clin. Anat. 30:352-356, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  16. Respiratory muscle involvement in sarcoidosis.

    Science.gov (United States)

    Schreiber, Tina; Windisch, Wolfram

    2018-07-01

    In sarcoidosis, muscle involvement is common, but mostly asymptomatic. Currently, little is known about respiratory muscle and diaphragm involvement and function in patients with sarcoidosis. Reduced inspiratory muscle strength and/or a reduced diaphragm function may contribute to exertional dyspnea, fatigue and reduced health-related quality of life. Previous studies using volitional and non-volitional tests demonstrated a reduced inspiratory muscle strength in sarcoidosis compared to control subjects, and also showed that respiratory muscle function may even be significantly impaired in a subset of patients. Areas covered: This review examines the evidence on respiratory muscle involvement and its implications in sarcoidosis with emphasis on pathogenesis, diagnosis and treatment of respiratory muscle dysfunction. The presented evidence was identified by a literature search performed in PubMed and Medline for articles about respiratory and skeletal muscle function in sarcoidosis through to January 2018. Expert commentary: Respiratory muscle involvement in sarcoidosis is an underdiagnosed condition, which may have an important impact on dyspnea and health-related quality of life. Further studies are needed to understand the etiology, pathogenesis and extent of respiratory muscle involvement in sarcoidosis.

  17. ACL injury: How do the physical examination tests compare?

    Science.gov (United States)

    Koster, Christiaan H; Harmsen, Annelieke Mk; Lichtenberg, Miranda C; Bloemers, Frank W

    2018-03-01

    Three physical examination tests are most commonly used to evaluate cruciate ligament injury. The best known and most frequently used technique is the anterior drawer test. The other 2 tests, the Lachman test and the pivot shift test, are more difficult to perform and are used less often, especially by physicians untrained in their use. In addition, there is a relatively new diagnostic test: the lever sign test. The aim of our article is to provide a short, clinically relevant overview of the literature and to assess the diagnostic value of physical examination for the primary care physician.

  18. Respiratory guiding system for respiratory motion management in respiratory gated radiotherapy

    International Nuclear Information System (INIS)

    Kang, Seong Hee; Kim, Dong Su; Kim, Tae Ho; Suh, Tae Suk

    2013-01-01

    Respiratory guiding systems have been shown to improve the respiratory regularity. This, in turn, improves the efficiency of synchronized moving aperture radiation therapy, and it reduces the artifacts caused by irregular breathing in imaging techniques such as four-dimensional computed tomography (4D CT), which is used for treatment planning in RGRT. We have previously developed a respiratory guiding system that incorporates an individual-specific guiding waveform, which is easy to follow for each volunteer, to improve the respiratory regularity. The present study evaluates the application of this system to improve the respiratory regularity for respiratory-gated radiation therapy (RGRT). In this study, we evaluated the effectiveness of an in-house-developed respiratory guiding system incorporating an individual specific guiding waveform to improve the respiratory regularity for RGRT. Most volunteers showed significantly less residual motion at each phase during guided breathing owing to the improvement in respiratory regularity. Therefore, the respiratory guiding system can clearly reduce the residual, or respiratory, motion in each phase. From the result, the CTV and the PTV margins during RGRT can be reduced by using the respiratory guiding system, which reduces the residual motions, thus improving the accuracy of RGRT

  19. Auscultation of the respiratory system

    Science.gov (United States)

    Sarkar, Malay; Madabhavi, Irappa; Niranjan, Narasimhalu; Dogra, Megha

    2015-01-01

    Auscultation of the lung is an important part of the respiratory examination and is helpful in diagnosing various respiratory disorders. Auscultation assesses airflow through the trachea-bronchial tree. It is important to distinguish normal respiratory sounds from abnormal ones for example crackles, wheezes, and pleural rub in order to make correct diagnosis. It is necessary to understand the underlying pathophysiology of various lung sounds generation for better understanding of disease processes. Bedside teaching should be strengthened in order to avoid erosion in this age old procedure in the era of technological explosion. PMID:26229557

  20. Auscultation of the respiratory system

    Directory of Open Access Journals (Sweden)

    Malay Sarkar

    2015-01-01

    Full Text Available Auscultation of the lung is an important part of the respiratory examination and is helpful in diagnosing various respiratory disorders. Auscultation assesses airflow through the trachea-bronchial tree. It is important to distinguish normal respiratory sounds from abnormal ones for example crackles, wheezes, and pleural rub in order to make correct diagnosis. It is necessary to understand the underlying pathophysiology of various lung sounds generation for better understanding of disease processes. Bedside teaching should be strengthened in order to avoid erosion in this age old procedure in the era of technological explosion.

  1. Short communication: final year students' deficits in physical examination skills performance in Germany.

    Science.gov (United States)

    Krautter, Markus; Diefenbacher, Katja; Koehl-Hackert, Nadja; Buss, Beate; Nagelmann, Lars; Herzog, Wolfgang; Jünger, Jana; Nikendei, Christoph

    2015-01-01

    The physical examination of patients is an important diagnostic competence, but little is known about the examination skills of final-year medical students. To investigate physical examination skills of final-year medical students. In a cross-sectional study, 40 final-year students were asked to perform a detailed physical examination on standardized patients. Their performances were video-recorded and rated by independent video assessors. Video ratings showed a mean success rate of 40.1 % (SD 8.2). As regards accompanying doctor-patient communication, final-year students achieved a mean of no more than 36.7 % (SD 8.9) in the appropriate use of the corresponding communication items. Our study revealed severe deficits among final-year medical students in performing a detailed physical examination on a standardized patient. Thus, physical examination skills training should aim to improve these deficits while also paying attention to communicative aspects. Copyright © 2015. Published by Elsevier GmbH.

  2. [Importance of history and physical examination for the care of nurses].

    Science.gov (United States)

    Santos, Neuma; Veiga, Patrícia; Andrade, Renata

    2011-01-01

    The history and physical examination are part of data collection of the Nursing Process. Its implementation is aimed at individualized care, holistic, humane and scientific foundation. The literature review was carried out in indexed databases as LILACS and SciELO, books and journals available in local libraries as published between the years 2000 to 2009. The aim is to describe the importance of clinical history and physical examination in the care provided by nurses. The results of this research will enable nursing students and health professionals can better understand the importance of history taking and physical examination to their professional practice, implement properly all stages of NAS and arouse interest in research on this topic.

  3. Physical articular examination in the activity of rheumatoid arthritis: a systematic review of the literature : Systematic review of the literature regarding physical examination in rheumatoid arthritis.

    Science.gov (United States)

    Medina, Yimy F; Ruíz-Gaviria, Rafael Eduardo; Buitrago-Lopez, Adriana; Villota, Catalina

    2018-06-01

    To summarize evidence concerning the articular examination needed to determine rheumatoid arthritis (RA) activity (follow-up or control) via a systematic review. A search of Medline, Embase, Lilacs, SciELO, the Web of Science, the National Technical Reports Library, and the reference lists of relevant studies through March 2017 was conducted using a systematic methodology to identify studies of patients with RA older than 18 years in which a detailed description of the physical examination or a description of the components of the articular examination was provided. Of 8322 references, 74 studies were included according to the selection criteria, and 6 references were ultimately included at the end of the review. Most of the included studies (n = 5) were associated with a moderate risk of bias. There was great variability among the studies and the articular examination methods used. Some studies presented the examination with a complete specification of the technique (n = 2), the consensus of rheumatologists (n = 2), or training through audiovisual materials and face-to-face courses (n = 2), but none of the studies explicitly showed the technique by which the physical examination was performed. Despite the importance of the clinical evaluation and physical examination of patients with RA for diagnosis, prognosis, clinimetrics, and follow-up, evidence concerning how to perform the articular examination is scarce.

  4. Physical examination of the hemodialysis arteriovenous fistula to detect early dysfunction.

    Science.gov (United States)

    Abreo, Kenneth; Amin, Bakhtiar M; Abreo, Adrian P

    2018-04-01

    The maintenance of vascular access patency for end-stage renal disease patients on hemodialysis is necessary for survival. Many nephrologists, nurse practitioners, and nurses have limited experience with the physical examination of the arteriovenous fistula. In this review, we define key terms used in the assessment of an arteriovenous fistula. We discuss the arteriovenous fistula physical exam, including details of inspection, palpation, and auscultation. Using these concepts, we review the abnormal findings that can assist practitioners in determining the location of a stenosis. We review the existing literature that validates physical exam findings with gold standard tests such as ultrasound and angiography. Finally, we review data supporting the value of training physicians and nurses in arteriovenous fistula physical examination.

  5. A new paradigm in respiratory hygiene: modulating respiratory secretions to contain cough bioaerosol without affecting mucus clearance

    Directory of Open Access Journals (Sweden)

    Bonilla Gloria

    2007-08-01

    Full Text Available Abstract Background Several strategies and devices have been designed to protect health care providers from acquiring transmissible respiratory diseases while providing care. In modulating the physical characteristics of the respiratory secretions to minimize the aerosolization that facilitates transmission of airborne diseases, a fundamental premise is that the prototype drugs have no adverse effect on the first line of respiratory defense, clearance of mucus by ciliary action. Methods To assess and demonstrate the primary mechanism of our mucomodulators (XLs, we have built our evidence moving from basic laboratory studies to an ex-vivo model and then to an in-vivo large animal model. We exposed anesthetized dogs without hypersecretion to different dose concentrations of aerosolized XL "B", XL "D" and XL "S". We assessed: cardio-respiratory pattern, tracheal mucus clearance, airway patency, and mucus viscoelastic changes. Results Exposure of frog palate mucus to XLs did not affect the clearance of mucus by ciliary action. Dogs maintained normal cardio-respiratory pattern with XL administration. Tracheal mucociliary clearance in anesthetized dogs indicated a sustained 40% mean increase. Tracheal mucus showed increased filance, and there was no mucus retention in the airways. Conclusion The ex-vivo frog palate and the in-vivo mammalian models used in this study, appear to be appropriate and complement each other to better assess the effects that our mucomodulators exert on the mucociliary clearance defence mechanism. The physiological function of the mucociliary apparatus was not negatively affected in any of the two epithelial models. Airway mucus crosslinked by mucomodulators is better cleared from an intact airway and normally functioning respiratory system, either due to enhanced interaction with cilia or airflow-dependent mechanisms. Data obtained in this study allow us to assure that we have complied with the fundamental requirement

  6. Measurements of respiratory illness among construction painters.

    OpenAIRE

    White, M C; Baker, E L

    1988-01-01

    The prevalence of different measurements of respiratory illness among construction painters was examined and the relation between respiratory illness and employment as a painter assessed in a cross sectional study of current male members of two local affiliates of a large international union of painters. Respiratory illness was measured by questionnaire and spirometry. Longer employment as a painter was associated with increased prevalence of chronic obstructive disease and an interactive eff...

  7. Utility of the physical examination in detecting pulmonary hypertension. A mixed methods study.

    Science.gov (United States)

    Colman, Rebecca; Whittingham, Heather; Tomlinson, George; Granton, John

    2014-01-01

    Patients with pulmonary hypertension (PH) often present with a variety of physical findings reflecting a volume or pressure overloaded right ventricle (RV). However, there is no consensus regarding the diagnostic utility of the physical examination in PH. We conducted a systematic review of publications that evaluated the clinical examination and diagnosis of PH using MEDLINE (1946-2013) and EMBASE (1947-2013). We also prospectively evaluated the diagnostic utility of the physical examination findings. Patients who underwent right cardiac catheterization for any reason were recruited. After informed consent, participants were examined by 6 physicians (3 "specialists" and 3 "generalists") who were unaware of the results of the patient's hemodynamics. Each examiner independently assessed patients for the presence of a RV lift, loud P2, jugular venous distension (JVD), tricuspid insufficiency murmur and right-sided 4th heart sound at rest and during a slow inspiration. A global rating (scale of 1-5) of the likelihood that the patient had pulmonary hypertension was provided by each examiner. 31 articles that assessed the physical examination in PH were included in the final analysis. There was heterogeneity amongst the studies and many did not include control data. The sign most associated with PH in the literature was a loud pulmonic component of the second heart sound (P2). In our prospective study physical examination was performed on 52 subjects (25 met criteria for PH; mPAP ≥ 25 mmHg). The physical sign with the highest likelihood ratio (LR) was a loud P2 on inspiration with a LR +ve 1.9, 95% CrI [1.2, 3.1] when data from all examiners was analyzed together. Results from the specialist examiners had higher diagnostic utility; a loud P2 on inspiration was associated with a positive LR of 3.2, 95% CrI [1.5, 6.2] and a right sided S4 on inspiration had a LR +ve 4.7, 95% CI [1.0, 15.6]. No aspect of the physical exam, could consistently rule out PH (negative LRs 0

  8. Upper Respiratory Tract Diseases in Athletes in Different Sports Disciplines

    OpenAIRE

    Ga??zka-Franta, Anna; Jura-Szo?tys, Edyta; Sm??ka, Wojciech; Gawlik, Rados?aw

    2016-01-01

    Abstract Upper respiratory tract diseases in athletes are a very common medical problem. Training conditions in different sports disciplines increase the risk of upper respiratory disease. Epidemiological evidence suggests that heavy acute or chronic exercise is related to an increased incidence of upper respiratory tract infections in athletes. Regular physical exercise at high intensity may lead to transient immunosuppression due to high prevalence of allergic diseases in athletes. Regardle...

  9. Cardiopulmonary function of Young bronchitics (mostly mineworkers) before and after respiratory physiotherapy and physical training. Comparison with a control group

    Energy Technology Data Exchange (ETDEWEB)

    Marcq, M.; Minette, A.

    1981-01-01

    This article covers the effects of 4 weeks' treatment consisting of respiratory physiotherapy associated with physical training on cardiopulmonary function. It involved 12 patients (updated group) suffering from chronic bronchitis, still at an early stage in clinical terms. All patients showed signs of early broncho-destructive problems. This research was carried out with financial aid from the EEC (Agreement No. 7246-30-2-001). (32 refs.)

  10. Assessment of Respiratory Function in Students, Residing in Different Industrial Areas

    Directory of Open Access Journals (Sweden)

    Aiman E. Konkabaeva

    2013-01-01

    Full Text Available The article considers the results of the examination of three groups of apparently healthy volunteer students of one social group, both men and women, without bad habits, aged 19-22. Students live in three different industrial areas of Central Khazakhstan, containing ironworks (Temirtau and non-ferrous smelters (Balkhash, Zhezkazgan. It determined the necessity of respiratory function examination, using automated lung tester. The examination of respiratory function determined the decrease of the following parameters: lung vital capacity, maximal expiratory flow volume, forced expiratory volume 1, peak expiratory flow rate, cardiac minute output 25-50 if compared to proper parameters. The examination enabled us to make the conclusion that respiratory function is restricted due to high respiratory load, caused by air pollution. Changes intensity is different and can indicate the pollution in the examined areas.

  11. Special physical examination tests for superior labrum anterior-posterior shoulder tears: an examination of clinical usefulness.

    Science.gov (United States)

    Sandrey, Michelle A

    2013-01-01

    Calvert E, Chambers GK, Regan W, Hawkins RH, Leith JM. Special physical examination tests for superior labrum anterior-posterior shoulder injuries are clinically limited and invalid: a diagnostic systematic review. J Clin Epidemiol. 2009;62(5):558-563. The systematic review focused on diagnostic accuracy studies to determine if evidence was sufficient to support the use of superior labrum anterior-posterior (SLAP) physical examination tests as valid and reliable. The primary question was whether there was sufficient evidence in the published literature to support the use of SLAP physical examination tests as valid and reliable diagnostic test procedures. Studies published in English were identified through database searches on MEDLINE, EMBASE, and the Cochrane database (1970-2004) using the search term SLAP lesions. The medical subject headings of arthroscopy, shoulder joint, and athletic injuries were combined with test or testing, physical examination, and sensitivity and specificity to locate additional sources. Other sources were identified by rereviewing the reference lists of included studies and review articles. Studies were eligible based on the following criteria: (1) published in English, (2) focused on the physical examination of SLAP lesions, and (3) presented original data. A study was excluded if the article was limited to a clinical description of 1 or more special tests without any research focus to provide clinical accuracy data or if it did not focus on the topic. The abstracts that were located through the search strategies were reviewed, and potentially relevant abstracts were selected. Strict epidemiologic methods were used to obtain and collate all relevant studies; the authors developed a study questionnaire to record study name, year of publication, study design, sample size, and statistics. Validity of the diagnostic test study was determined by applying the 5 criteria proposed by Calvert et al. If the study met the inclusion and validity

  12. Respiratory symptoms and functions in barn workers

    Directory of Open Access Journals (Sweden)

    Ege Gulec Balbay

    2014-03-01

    Full Text Available Introduction and aim. The presented study was undertaken to investigate the respiratory health problems in family barns with one or more cows and at least one family member working in the barn. Methods. 150 workers (128 female, 22 male from 4 villages of Yığılca district near the city of Düzce in north-west Turkey were enrolled in this study between October – December 2011. An Occupational and Environmental Chest Diseases questionnaire developed by the American Thoracic Society, pulmonary function test, physical examination and investigation for nasal eosinophil were performed in all subjects. Results. The mean age of workers was 47.7 ± 14.2 years. Cough was present in 24% of subjects. The rates of phlegm, wheezing, chest tightness and dyspnea were 13.3%, 6%, 6% and 27.3%, respectively. Obstructive ventilatory pattern was observed in 37 workers (24.6%. 43 workers (28.6% showed restrictive ventilatory pattern. Nasal eosinophilia was detected in 47.3% (71/150 of the subjects. Pulmonary functions of workers with nasal eosinophilia did not differ from the other workers. There were statistically significant negative correlations between the duration of working in barns and respiratory functions. Conclusions. Pulmonary functions of barn workers have been found to be decreased related to the duration of barn working. Furthermore, respiratory symptoms increased in relation with both barn working and biomass consumption. Precautions should therefore be taken to ventilate both barns and houses.

  13. Longitudinal examination of social and environmental influences on motivation for physical activity.

    Science.gov (United States)

    Richards, Elizabeth A; McDonough, Meghan; Fu, Rong

    2017-10-01

    Physical activity behavior is influenced by numerous factors including motivation, social interactions, and the walkability of the environment. To examine how social contexts and environmental features affect physical activity motivational processes across time. Participants (N=104) completed 3 monthly online surveys assessing self-determination theory constructs, social partners in physical activity, neighborhood walkability, and weekly physical activity. Longitudinal path analysis examined the degree to which physical activity was predicted by individual goals, orientation, and autonomy support and whether these associations were meditated by motivation and moderated by the social and environmental contexts of physical activity. The effect of controlled exercise orientations on physical activity was mediated by autonomous motivation. This association was stronger among those who perceived less crime in their neighborhoods. To improve the ability to tailor physical activity counseling it is important to understand how each person views exercise situations and to understand his/her social and neighborhood environments. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. The FAMULATUR PLUS as an innovative approach for teaching physical examination skills.

    Science.gov (United States)

    Jerg, Achim; Öchsner, Wolfgang; Wander, Henriette; Traue, Harald C; Jerg-Bretzke, Lucia

    2016-01-01

    The FAMULATUR PLUS is an innovative approach to teaching physical examination skills. The concept is aimed at medical students during the clinical part of their studies and includes a clinical traineeship (English for "Famulatur") extended to include various courses ("PLUS"). The courses are divided into clinical examination courses and problembased-learning (PBL) seminars. The concept's special feature is the full integration of these courses into a 30-day hospital traineeship. The aim is to facilitate the transfer of knowledge from the courses into daily practice. Each week of the FAMULATUR PLUS is structured in line with the courses and focuses on a particular part of the body (e.g., abdomen). A physical examination course under the supervision of a physician is offered at the beginning of the week. Here, medical students learn the relevant examination techniques by practicing on each other (partner exercises). Subsequently, the techniques taught are applied independently during everyday work on the ward, corrected by the supervisor, if necessary, and thereby reinforced. The final POL seminar takes place towards the end of the week. Possible differential diagnoses are developed based on a clinical case study. The goal is to check these by taking a fictitious medical history and performing a physical examination, as well as to make a preliminary diagnosis. Finally, during the PBL seminar, medical students will be shown how physical examination techniques can be efficiently applied in the diagnosis of common cardinal symptoms (e.g., abdominal pain). The initial implementation of the FAMULATUR PLUS proved the practical feasibility of the concept. In addition, the accompanying evaluation showed that the participants of the pilot project improved with regard to their practical physical examination skills.

  15. Utility of the physical examination in detecting pulmonary hypertension. A mixed methods study.

    Directory of Open Access Journals (Sweden)

    Rebecca Colman

    Full Text Available INTRODUCTION: Patients with pulmonary hypertension (PH often present with a variety of physical findings reflecting a volume or pressure overloaded right ventricle (RV. However, there is no consensus regarding the diagnostic utility of the physical examination in PH. METHODS: We conducted a systematic review of publications that evaluated the clinical examination and diagnosis of PH using MEDLINE (1946-2013 and EMBASE (1947-2013. We also prospectively evaluated the diagnostic utility of the physical examination findings. Patients who underwent right cardiac catheterization for any reason were recruited. After informed consent, participants were examined by 6 physicians (3 "specialists" and 3 "generalists" who were unaware of the results of the patient's hemodynamics. Each examiner independently assessed patients for the presence of a RV lift, loud P2, jugular venous distension (JVD, tricuspid insufficiency murmur and right-sided 4th heart sound at rest and during a slow inspiration. A global rating (scale of 1-5 of the likelihood that the patient had pulmonary hypertension was provided by each examiner. RESULTS: 31 articles that assessed the physical examination in PH were included in the final analysis. There was heterogeneity amongst the studies and many did not include control data. The sign most associated with PH in the literature was a loud pulmonic component of the second heart sound (P2. In our prospective study physical examination was performed on 52 subjects (25 met criteria for PH; mPAP ≥ 25 mmHg. The physical sign with the highest likelihood ratio (LR was a loud P2 on inspiration with a LR +ve 1.9, 95% CrI [1.2, 3.1] when data from all examiners was analyzed together. Results from the specialist examiners had higher diagnostic utility; a loud P2 on inspiration was associated with a positive LR of 3.2, 95% CrI [1.5, 6.2] and a right sided S4 on inspiration had a LR +ve 4.7, 95% CI [1.0, 15.6]. No aspect of the physical exam, could

  16. Utility of the Physical Examination in Detecting Pulmonary Hypertension. A Mixed Methods Study

    Science.gov (United States)

    Colman, Rebecca; Whittingham, Heather; Tomlinson, George; Granton, John

    2014-01-01

    Introduction Patients with pulmonary hypertension (PH) often present with a variety of physical findings reflecting a volume or pressure overloaded right ventricle (RV). However, there is no consensus regarding the diagnostic utility of the physical examination in PH. Methods We conducted a systematic review of publications that evaluated the clinical examination and diagnosis of PH using MEDLINE (1946–2013) and EMBASE (1947–2013). We also prospectively evaluated the diagnostic utility of the physical examination findings. Patients who underwent right cardiac catheterization for any reason were recruited. After informed consent, participants were examined by 6 physicians (3 “specialists” and 3 “generalists”) who were unaware of the results of the patient's hemodynamics. Each examiner independently assessed patients for the presence of a RV lift, loud P2, jugular venous distension (JVD), tricuspid insufficiency murmur and right-sided 4th heart sound at rest and during a slow inspiration. A global rating (scale of 1–5) of the likelihood that the patient had pulmonary hypertension was provided by each examiner. Results 31 articles that assessed the physical examination in PH were included in the final analysis. There was heterogeneity amongst the studies and many did not include control data. The sign most associated with PH in the literature was a loud pulmonic component of the second heart sound (P2). In our prospective study physical examination was performed on 52 subjects (25 met criteria for PH; mPAP ≥25 mmHg). The physical sign with the highest likelihood ratio (LR) was a loud P2 on inspiration with a LR +ve 1.9, 95% CrI [1.2, 3.1] when data from all examiners was analyzed together. Results from the specialist examiners had higher diagnostic utility; a loud P2 on inspiration was associated with a positive LR of 3.2, 95% CrI [1.5, 6.2] and a right sided S4 on inspiration had a LR +ve 4.7, 95% CI [1.0, 15.6]. No aspect of the physical exam, could

  17. Risk Factors, Pathobiomechanics and Physical Examination of Rotator Cuff Tears

    Science.gov (United States)

    Moulton, Samuel G.; Greenspoon, Joshua A.; Millett, Peter J.; Petri, Maximilian

    2016-01-01

    Background: It is important to appreciate the risk factors for the development of rotator cuff tears and specific physical examination maneuvers. Methods: A selective literature search was performed. Results: Numerous well-designed studies have demonstrated that common risk factors include age, occupation, and anatomic considerations such as the critical shoulder angle. Recently, research has also reported a genetic component as well. The rotator cuff axially compresses the humeral head in the glenohumeral joint and provides rotational motion and abduction. Forces are grouped into coronal and axial force couples. Rotator cuff tears are thought to occur when the force couples become imbalanced. Conclusion: Physical examination is essential to determining whether a patient has an anterosuperior or posterosuperior tear. Diagnostic accuracy increases when combining a series of examination maneuvers. PMID:27708731

  18. Exploration of the value of using a formula sheet for physics examinations

    International Nuclear Information System (INIS)

    Chang, Wheijen; Shieh, Ruey S

    2013-01-01

    The purpose of this study is to explore whether and how allowing students to prepare their own formula sheet (FS) for use in examinations helps them engage in meaningful learning and improve their academic performance. An action research is adopted to conduct the study. Three years (2009–11) of evaluation of the FS policy in introductory physics courses was undertaken. The data collection consists of the students' FS, examination results, and self-reported surveys. The results show that the students who were allowed to bring an FS to the examination outperformed those who were not. It is also found that the quality of individual students' FS was significantly correlated to their examination score (p < 0.001). The reported benefits of using an FS consists of facilitating conceptual understanding, highlighting cognitive demands in learning physics, and alleviating stress in examinations. The FS strategy appears to have the potential for strengthening students' understanding of physics concepts. (paper)

  19. Chemical and physical quality examination: Chapter 4

    Science.gov (United States)

    Lamar, William

    1953-01-01

    In a balanced study of water pollution or water utilization a thorough chemical and physical examination is essential. This provides a basis for evaluation of stream conditions, their effects and remedies. Such information is of value to the general public who are interested in clean water and in recreation, hunting, fishing, and wildlife; to the chemist, engineer, hydrologist, and industrialist who are interested in the domestic and industrial use of water both as raw material and as a vehicle for the removal of waste materials; to the sanitarian who is interested in healthful conditions; and to the biologist who is interested in maintaining a favorable biological balance. For every living plant and animal there are optimum physical and chemical conditions and these characteristics are determining factors in the aquatic life of any body of water.

  20. Physical examination tests for screening and diagnosis of cervicogenic headache: A systematic review.

    Science.gov (United States)

    Rubio-Ochoa, J; Benítez-Martínez, J; Lluch, E; Santacruz-Zaragozá, S; Gómez-Contreras, P; Cook, C E

    2016-02-01

    It has been suggested that differential diagnosis of headaches should consist of a robust subjective examination and a detailed physical examination of the cervical spine. Cervicogenic headache (CGH) is a form of headache that involves referred pain from the neck. To our knowledge, no studies have summarized the reliability and diagnostic accuracy of physical examination tests for CGH. The aim of this study was to summarize the reliability and diagnostic accuracy of physical examination tests used to diagnose CGH. A systematic review following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines was performed in four electronic databases (MEDLINE, Web of Science, Embase and Scopus). Full text reports concerning physical tests for the diagnosis of CGH which reported the clinometric properties for assessment of CGH, were included and screened for methodological quality. Quality Appraisal for Reliability Studies (QAREL) and Quality Assessment of Studies of Diagnostic Accuracy (QUADAS-2) scores were completed to assess article quality. Eight articles were retrieved for quality assessment and data extraction. Studies investigating diagnostic reliability of physical examination tests for CGH scored poorer on methodological quality (higher risk of bias) than those of diagnostic accuracy. There is sufficient evidence showing high levels of reliability and diagnostic accuracy of the selected physical examination tests for the diagnosis of CGH. The cervical flexion-rotation test (CFRT) exhibited both the highest reliability and the strongest diagnostic accuracy for the diagnosis of CGH. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Exercising upper respiratory videoendoscopic evaluation of 100 nonracing performance horses with abnormal respiratory noise and/or poor performance.

    Science.gov (United States)

    Davidson, E J; Martin, B B; Boston, R C; Parente, E J

    2011-01-01

    Although well documented in racehorses, there is paucity in the literature regarding the prevalence of dynamic upper airway abnormalities in nonracing performance horses. To describe upper airway function of nonracing performance horses with abnormal respiratory noise and/or poor performance via exercising upper airway videoendoscopy. Medical records of nonracing performance horses admitted for exercising evaluation with a chief complaint of abnormal respiratory noise and/or poor performance were reviewed. All horses had video recordings of resting and exercising upper airway endoscopy. Relationships between horse demographics, resting endoscopic findings, treadmill intensity and implementation of head and neck flexion during exercise with exercising endoscopic findings were examined. Dynamic upper airway obstructions were observed in 72% of examinations. Head and neck flexion was necessary to obtain a diagnosis in 21 horses. Pharyngeal wall collapse was the most prevalent upper airway abnormality, observed in 31% of the examinations. Complex abnormalities were noted in 27% of the examinations. Resting laryngeal dysfunction was significantly associated with dynamic arytenoid collapse and the odds of detecting intermittent dorsal displacement of the soft palate (DDSP) during exercise in horses with resting DDSP was only 7.7%. Exercising endoscopic observations were different from the resting observations in 54% of examinations. Dynamic upper airway obstructions were common in nonracing performance horses with respiratory noise and/or poor performance. Resting endoscopy was only helpful in determining exercising abnormalities with recurrent laryngeal neuropathy. This study emphasises the importance of exercising endoscopic evaluation in nonracing performance horses with abnormal respiratory noise and/or poor performance for accurate assessment of dynamic upper airway function. © 2010 EVJ Ltd.

  2. Using web-based video to enhance physical examination skills in medical students.

    Science.gov (United States)

    Orientale, Eugene; Kosowicz, Lynn; Alerte, Anton; Pfeiffer, Carol; Harrington, Karen; Palley, Jane; Brown, Stacey; Sapieha-Yanchak, Teresa

    2008-01-01

    Physical examination (PE) skills among U.S. medical students have been shown to be deficient. This study examines the effect of a Web-based physical examination curriculum on first-year medical student PE skills. Web-based video clips, consisting of instruction in 77 elements of the physical examination, were created using Microsoft Windows Moviemaker software. Medical students' PE skills were evaluated by standardized patients before and after implementation of the Internet-based video. Following implementation of this curriculum, there was a higher level of competency (from 87% in 2002-2003 to 91% in 2004-2005), and poor performances on standardized patient PE exams substantially diminished (from a 14%-22%failure rate in 2002-2003, to 4% in 2004-2005. A significant improvement in first-year medical student performance on the adult PE occurred after implementing Web-based instructional video.

  3. Medical educators' perspectives of teaching physical examinations using ultrasonography at the undergraduate level

    Directory of Open Access Journals (Sweden)

    Irene Ma

    2013-03-01

    Full Text Available Background: Ultrasonography is increasingly used for teaching physical examination in medical schools. This study seeks the opinions of educators as to which physical examinations would be most enhanced by the addition of ultrasonography. We also asked when ultrasound-aided physical examination teaching could have deleterious effects if used outside its intended scope. Methods: All of the educators from the University of Calgary Master Teacher Program were invited to complete a 22-item paper-based survey. Survey items were generated independently by two investigators, with input from an expert panel (N = 5. Results: Of the 36 educators, 27 (75% completed the survey. Examinations identified to be potentially most useful included: measuring the size of the abdominal aorta, identifying the presence/absence of ascites, identifying the presence/absence of pleural effusions, and measuring the size of the bladder. Examinations thought to be potentially most harmful included: identifying the presence/absence of intrauterine pregnancy, measuring the size of the abdominal aorta, and identifying the presence/absence of pericardial effusion. Conclusions: Examinations that are potentially the most useful may also be potentially the most harmful. When initiating an ultrasound curriculum for physical examinations, educators should weigh the risks and benefits of examinations chosen.

  4. The FAMULATUR PLUS as an innovative approach for teaching physical examination skills

    Directory of Open Access Journals (Sweden)

    Jerg, Achim

    2016-02-01

    Full Text Available The FAMULATUR PLUS is an innovative approach to teaching physical examination skills. The concept is aimed at medical students during the clinical part of their studies and includes a clinical traineeship (English for “Famulatur” extended to include various courses (“PLUS”. The courses are divided into clinical examination courses and problembased-learning (PBL seminars. The concept’s special feature is the full integration of these courses into a 30-day hospital traineeship. The aim is to facilitate the transfer of knowledge from the courses into daily practice. Each week of the FAMULATUR PLUS is structured in line with the courses and focuses on a particular part of the body (e.g., abdomen. A physical examination course under the supervision of a physician is offered at the beginning of the week. Here, medical students learn the relevant examination techniques by practicing on each other (partner exercises. Subsequently, the techniques taught are applied independently during everyday work on the ward, corrected by the supervisor, if necessary, and thereby reinforced. The final POL seminar takes place towards the end of the week. Possible differential diagnoses are developed based on a clinical case study. The goal is to check these by taking a fictitious medical history and performing a physical examination, as well as to make a preliminary diagnosis. Finally, during the PBL seminar, medical students will be shown how physical examination techniques can be efficiently applied in the diagnosis of common cardinal symptoms (e.g., abdominal pain. The initial implementation of the FAMULATUR PLUS proved the practical feasibility of the concept. In addition, the accompanying evaluation showed that the participants of the pilot project improved with regard to their practical physical examination skills.

  5. Chaperones and intimate physical examinations: what do male and female patients want?

    Science.gov (United States)

    Fan, V C; Choy, H T; Kwok, G Yj; Lam, H G; Lim, Q Y; Man, Y Y; Tang, C K; Wong, C C; Yu, Y F; Leung, G Kk

    2017-02-01

    Many studies of patients' perception of a medical chaperone have focused on female patients; that of male patients are less well studied. Moreover, previous studies were largely based on patient populations in English-speaking countries. Therefore, this study was conducted to investigate the perception and attitude of male and female Chinese patients to the presence of a chaperone during an intimate physical examination. A cross-sectional guided questionnaire survey was conducted on a convenient sample of 150 patients at a public teaching hospital in Hong Kong. Over 90% of the participants considered the presence of a chaperone appropriate during intimate physical examination, and 84% felt that doctors, irrespective of gender, should always request the presence of a chaperone. The most commonly cited reasons included the availability of an objective account should any legal issue arise, protection against sexual harassment, and to provide psychological support. This contrasted with the experience of those who had previously undergone an intimate physical examination of whom only 72.6% of women and 35.7% of men had reportedly been chaperoned. Among female participants, 75.0% preferred to be chaperoned during an intimate physical examination by a male doctor, and 28.6% would still prefer to be chaperoned when being examined by a female doctor. Among male participants, over 50% indicated no specific preference but a substantial minority reported a preference for chaperoned examination (21.2% for male doctor and 25.8% for female doctor). Patients in Hong Kong have a high degree of acceptance and expectations about the role of a medical chaperone. Both female and male patients prefer such practice regardless of physician gender. Doctors are strongly encouraged to discuss the issue openly with their patients before they conduct any intimate physical examination.

  6. A core physical examination in internal medicine: what should students do and how about their supervisors?

    Science.gov (United States)

    Haring, Catharina M; van der Meer, Jos W M; Postma, Cornelis T

    2013-09-01

    Performance of a focused physical examination will induce a high cognitive load for medical students in the early phase of the clinical clerkships. To come to a workable and clinically applicable standard physical examination for medical students to be used in every new patient in the daily clinical practice of internal medicine. A questionnaire held among physicians that supervise students during the clerkship of internal medicine in one Dutch training region. Of the complete list of physical examination 55 items were considered to be an integral part of the standard general physical examination for medical students. Most emphasized were elements of the physical examination aimed at general parameters, thorax and abdomen, vascular status, lymph nodes, spinal column, skin and some parts of the neurological examination. The standard physical examinations performed by supervisors themselves contain fewer items than they expected from the students. The expectations a supervisor has towards the student correlates with the frequency with which they apply the various components in their own physical examination. This study provides us with a 'core' physical examination for medical students that can be applied in the early phase of the clinical clerkships.

  7. Lung injury and respiratory mechanics in rugby union.

    Science.gov (United States)

    Lindsay, Angus; Bernard, Angelique; Davidson, Shaun M; Redmond, Daniel P; Chiew, Yeong S; Pretty, Christopher; Chase, J Geoffrey; Shaw, Geoffrey M; Gieseg, Steven P; Draper, Nick

    2016-04-01

    Rugby is a highly popular team contact sport associated with high injury rates. Specifically, there is a chance of inducing internal lung injuries as a result of the physical nature of the game. Such injuries are only identified with the use of specific invasive protocols or equipment. This study presents a model-based method to assess respiratory mechanics of N=11 rugby players that underwent a low intensity experimental Mechanical Ventilation (MV) Test before and after a rugby game. Participants were connected to a ventilator via a facemask and their respiratory mechanics estimated using a time-varying elastance model. All participants had a respiratory elastance respiratory mechanics (P>0.05). Model-based respiratory mechanics estimation has been used widely in the treatment of the critically ill in intensive care. However, the application of a ventilator to assess the respiratory mechanics of healthy human beings is limited. This method adapted from ICU mechanical ventilation can be used to provide insight to respiratory mechanics of healthy participants that can be used as a more precise measure of lung inflammation/injury that avoids invasive procedures. This is the first study to conceptualize the assessment of respiratory mechanics in healthy athletes as a means to monitor postexercise stress and therefore manage recovery.

  8. Reliability of Examination Findings in Suspected Community-Acquired Pneumonia.

    Science.gov (United States)

    Florin, Todd A; Ambroggio, Lilliam; Brokamp, Cole; Rattan, Mantosh S; Crotty, Eric J; Kachelmeyer, Andrea; Ruddy, Richard M; Shah, Samir S

    2017-09-01

    The authors of national guidelines emphasize the use of history and examination findings to diagnose community-acquired pneumonia (CAP) in outpatient children. Little is known about the interrater reliability of the physical examination in children with suspected CAP. This was a prospective cohort study of children with suspected CAP presenting to a pediatric emergency department from July 2013 to May 2016. Children aged 3 months to 18 years with lower respiratory signs or symptoms who received a chest radiograph were included. We excluded children hospitalized ≤14 days before the study visit and those with a chronic medical condition or aspiration. Two clinicians performed independent examinations and completed identical forms reporting examination findings. Interrater reliability for each finding was reported by using Fleiss' kappa (κ) for categorical variables and intraclass correlation coefficient (ICC) for continuous variables. No examination finding had substantial agreement (κ/ICC > 0.8). Two findings (retractions, wheezing) had moderate to substantial agreement (κ/ICC = 0.6-0.8). Nine findings (abdominal pain, pleuritic pain, nasal flaring, skin color, overall impression, cool extremities, tachypnea, respiratory rate, and crackles/rales) had fair to moderate agreement (κ/ICC = 0.4-0.6). Eight findings (capillary refill time, cough, rhonchi, head bobbing, behavior, grunting, general appearance, and decreased breath sounds) had poor to fair reliability (κ/ICC = 0-0.4). Only 3 examination findings had acceptable agreement, with the lower 95% confidence limit >0.4: wheezing, retractions, and respiratory rate. In this study, we found fair to moderate reliability of many findings used to diagnose CAP. Only 3 findings had acceptable levels of reliability. These findings must be considered in the clinical management and research of pediatric CAP. Copyright © 2017 by the American Academy of Pediatrics.

  9. Physical Examination Findings Among Children and Adolescents With Obesity: An Evidence-Based Review.

    Science.gov (United States)

    Armstrong, Sarah; Lazorick, Suzanne; Hampl, Sarah; Skelton, Joseph A; Wood, Charles; Collier, David; Perrin, Eliana M

    2016-02-01

    Overweight and obesity affects 1 in 3 US children and adolescents. Clinical recommendations have largely focused on screening guidelines and counseling strategies. However, the physical examination of the child or adolescent with obesity can provide the clinician with additional information to guide management decisions. This expert-based review focuses on physical examination findings specific to children and adolescents with obesity. For each physical examination element, the authors define the finding and its prevalence among pediatric patients with obesity, discuss the importance and relevance of the finding, describe known techniques to assess severity, and review evidence regarding the need for additional evaluation. The recommendations presented represent a comprehensive review of current evidence as well as expert opinion. The goal of this review is to highlight the importance of conducting a targeted physical examination during pediatric weight management visits. Copyright © 2016 by the American Academy of Pediatrics.

  10. Seasonal variation of maternally derived respiratory syncytial virus antibodies and association with infant hospitalizations for respiratory syncytial virus

    DEFF Research Database (Denmark)

    Stensballe, Lone Graff; Ravn, Henrik; Kristensen, Kim

    2009-01-01

    This study used 459 prospectively sampled cord blood samples to examine the association between maternally derived respiratory syncytial virus (RSV)-neutralizing antibodies and the RSV hospitalization season in Denmark. We found a clear temporal association and suggest that RSV-neutralizing antib......This study used 459 prospectively sampled cord blood samples to examine the association between maternally derived respiratory syncytial virus (RSV)-neutralizing antibodies and the RSV hospitalization season in Denmark. We found a clear temporal association and suggest that RSV......-neutralizing antibody level plays a role in the RSV seasonal pattern....

  11. Associations between physical examination, laboratory, and radiographic findings and outcome and subsequent racing performance of foals with Rhodococcus equi infection: 115 cases (1984-1992)

    International Nuclear Information System (INIS)

    Ainsworth, D.M.; Eicker, S.W.; Yeager, A.E.; Sweeney, C.R.; Viel, L.; Tesarowski, D.; Lavoie, J.P.; Hoffman, A.; Paradis, M.R.; Reed, S.M.

    1998-01-01

    Objective-To determine whether physical examination, laboratory, or radiographic abnormalities in foals with Rhodococcus equi infection were associated with survival, ability to race at least once after recovery, or, for foals that survived and went on to race, subsequent Facing performance. Design-Retrospective study. Animals-49 Thoroughbreds and 66 Standardbreds admitted to 1 of 6 veterinary teaching hospitals between 1984 and 1992 in which R equi infection was positively diagnosed. Procedure-Results of physical examination, laboratory testing, and thoracic radiography were reviewed. Indices of Facing performance were obtained for feats that recovered and eventually raced and compared with values for the US racing population. Results-83 (72%) feats survived. Foals that did not survive were more likely to have extreme tachycardia (heart rate > 100 beats/min), be in respiratory distress, and have severe radiographic abnormalities on thoracic radiographs at the time of initial examination than were foals that survived. Clinicopathologic abnormalities were not associated with whether feats did or did not survive. Forty-five of the 83 surviving foals (54%) eventually raced at least once, but none of the factors examined was associated with whether foals went on to race. Racing performance of foals that raced as adults was not significantly different from that of the US racing population. Clinical Implications-R equi infection in foals is associated with a decreased chance of racing as an adult, however, foals that eventually go on to race perform comparably to the US racing population

  12. Effect of respiratory function training on respiratory function of patients with severe cerebrovascular disease

    Directory of Open Access Journals (Sweden)

    Ming GUO

    2017-07-01

    Full Text Available Objective To investigate the effect of respiratory function training on respiratory function and conscious state of patients with severe cerebrovascular disease (SCVD.  Methods A total of 27 patients with SCVD were divided into control group (N = 17 and observation group (N = 10. Control group received routine drug and rehabilitation treatment, and observation group was added respiratory function training based on routine treatment. The respiratory rate, tidal volume (TV, heart rate, blood pressure and artery oxygen saturation (SaO2 of patients were monitored by breathing machine before and after 4-week treatment. Meanwhile, arterial blood gas analysis was used to detect arterial partial pressure of oxygen (PaO2, oxygenation index, partial pressure of carbon dioxide (PaCO2 and pH value. At the same time, Glasgow Coma Scale (GCS was used to evaluate the conscious state of patients.  Results All patients successfully completed 4-week rehabilitation training, without asphyxia, arrhythmia or other adverse events. Compared with before training, the respiratory rate (P = 0.006 and pH value (P = 0.010 were significantly decreased, while SaO2 (P = 0.001, oxygenation index (P = 0.000 and GCS scores (P = 0.004, 0.017 were significantly increased in both groups of patients after training. There was no statistically significant difference between 2 groups on respiratory function indexes and GCS scores after training (P > 0.05, for all. Conclusions Respiratory function training did not significantly improve the respiratory function and conscious state of patients with SCVD, yet to be further studied. Randomized controlled clinical trials with larger, layered samples and long-term prognosis observation are needed. Examination method of respiratory function of SCVD patients is also a topic to be explored.  DOI: 10.3969/j.issn.1672-6731.2017.04.007

  13. Canada's Physical Activity Guide: examining print-based material for motivating physical activity in the workplace.

    Science.gov (United States)

    Plotnikoff, Ronald C; Todosijczuk, Ivan; Johnson, Steven T; Karunamuni, Nandini

    2012-01-01

    The authors conducted a secondary analysis on 202 adults from the Physical Activity Workplace Study. The aim of this analysis was to examine demographic characteristics associated with reading Canada's Physical Activity Guide (CPAG), being motivated by the guide, and whether participants in the Physical Activity Workplace Study who read the CPAG increased their physical activity levels over 1 year. Results revealed that less than 50% of participants read the full version of CPAG, and less than 10% were motivated by it. The CPAG also appears to be more appealing to and effective for women than for men. Although the CPAG had some influence in increasing mild physical activity levels in a workplace sample, there was also a decrease in physical activity levels among some members of the group. Overall, the effectiveness of CPAG was not substantial, and the findings of this analysis could help guide future targeted intervention materials and programs.

  14. Severe Respiratory Failure in the Coexistence of Polymyositis and Hypothyroidism: A Case Report

    Directory of Open Access Journals (Sweden)

    Fatih Yildiz

    2013-08-01

    Full Text Available Polymyositis is a systemic, inflammatory muscle disease. Respiratory insufficiency as a result of respiratory muscle involvement could also be observed. Here we report a fortyone-year-old man who attended to the hospital with the complaints of shortness of breath and chest pain that have suddenly started. Physical examination has revealed proximal muscle weakness. Serum creatinine phosphokinase level has increased, ANA was positive and the electromyographic examination has revealed myopathic changes. Deltoid muscle biopsy was in accordance with polymyositis. Methyl-prednisolone 1 gram iv pulse therapy was given during the first 5 days. He was started with 25 mg/week parenteral methotrexate. Laboratory tests suggested hypothyroidism and levothyroxine replacement therapy was started. The clinical findings have improved concomitant with the reduction in the muscle enzymes and thyroid stimulant hormone levels into the normal ranges. He was discharged with the recommendation of the NIMV device application during night-time. The clinical symptoms are more severe in the presence of alveolar hypoventilation due to polymyositis and coincidantal hypothyroidism. [Cukurova Med J 2013; 38(4.000: 744-750

  15. Perioperative modifications of respiratory function.

    LENUS (Irish Health Repository)

    Duggan, Michelle

    2012-01-31

    Postoperative pulmonary complications contribute considerably to morbidity and mortality, especially after major thoracic or abdominal surgery. Clinically relevant pulmonary complications include the exacerbation of underlying chronic lung disease, bronchospasm, atelectasis, pneumonia and respiratory failure with prolonged mechanical ventilation. Risk factors for postoperative pulmonary complications include patient-related risk factors (e.g., chronic obstructive pulmonary disease (COPD), tobacco smoking and increasing age) as well as procedure-related risk factors (e.g., site of surgery, duration of surgery and general vs. regional anaesthesia). Careful history taking and a thorough physical examination may be the most sensitive ways to identify at-risk patients. Pulmonary function tests are not suitable as a general screen to assess risk of postoperative pulmonary complications. Strategies to reduce the risk of postoperative pulmonary complications include smoking cessation, inspiratory muscle training, optimising nutritional status and intra-operative strategies. Postoperative care should include lung expansion manoeuvres and adequate pain control.

  16. Examining the Role of Physical Appearance in Latino Adolescents' Ethnic Identity

    Science.gov (United States)

    Gonzales-Backen, Melinda A.; Umana-Taylor, Adriana J.

    2011-01-01

    Guided by ecological theory, the current study examined physical appearance as a moderator of the relation between familial ethnic socialization (FES) and ethnic identity among 167 Latino adolescents. Results indicated that FES was positively associated with ethnic identity exploration and resolution. Furthermore, as expected, physical appearance…

  17. Telemedicine Physical Examination Utilizing a Consumer Device Demonstrates Poor Concordance with In-Person Physical Examination in Emergency Department Patients with Sore Throat: A Prospective Blinded Study.

    Science.gov (United States)

    Akhtar, Moneeb; Van Heukelom, Paul G; Ahmed, Azeemuddin; Tranter, Rachel D; White, Erinn; Shekem, Nathaniel; Walz, David; Fairfield, Catherine; Vakkalanka, J Priyanka; Mohr, Nicholas M

    2018-02-22

    Telemedicine allows patients to connect with healthcare providers remotely. It has recently expanded to evaluate low-acuity illnesses such as pharyngitis by using patients' personal communication devices. The purpose of our study was to compare the telemedicine-facilitated physical examination with an in-person examination in emergency department (ED) patients with sore throat. This was a prospective, observational, blinded diagnostic concordance study of patients being seen for sore throat in a 60,000-visit Midwestern academic ED. A telemedicine and a face-to-face examination were performed independently by two advanced practice providers (APP), blinded to the results of the other evaluator. The primary outcome was agreement on pharyngeal redness between the evaluators, with secondary outcomes of agreement and inter-rater reliability on 14 other aspects of the pharyngeal physical examination. We also conducted a survey of patients and providers to evaluate perceptions and preferences for sore throat evaluation using telemedicine. Sixty-two patients were enrolled, with a median tonsil size of 1.0. Inter-rater agreement (kappa) for tonsil size was 0.394, which was worse than our predetermined concordance threshold. Other kappa values ranged from 0 to 0.434, and telemedicine was best for detecting abnormal coloration of the palate and tender superficial cervical lymph nodes (anterior structures), but poor for detecting abnormal submandibular lymph nodes or asymmetry of the posterior pharynx (posterior structures). In survey responses, telemedicine was judged easier to use and more comfortable for providers than patients; however, neither patients nor providers preferred in-person to telemedicine evaluation. Telemedicine exhibited poor agreement with the in-person physical examination on the primary outcome of tonsil size, but exhibited moderate agreement on coloration of the palate and cervical lymphadenopathy. Future work should better characterize the importance of

  18. Evaluation of respiratory pattern during respiratory-gated radiotherapy

    International Nuclear Information System (INIS)

    Dobashi, Suguru; Mori, Shinichiro

    2014-01-01

    The respiratory cycle is not strictly regular, and generally varies in amplitude and period from one cycle to the next. We evaluated the characteristics of respiratory patterns acquired during respiratory gating treatment in more than 300 patients. A total 331 patients treated with respiratory-gated carbon-ion beam therapy were selected from a group of patients with thoracic and abdominal conditions. Respiratory data were acquired for a total of 3,171 fractions using an external respiratory sensing monitor and evaluated for respiratory cycle, duty cycle, magnitude of baseline drift, and intrafractional/interfractional peak inhalation/exhalation positional variation. Results for the treated anatomical sites and patient positioning were compared. Mean ± SD respiratory cycle averaged over all patients was 4.1 ± 1.3 s. Mean ± SD duty cycle averaged over all patients was 36.5 ± 7.3 %. Two types of baseline drift were seen, the first decremental and the second incremental. For respiratory peak variation, the mean intrafractional variation in peak-inhalation position relative to the amplitude in the first respiratory cycle (15.5 ± 9.3 %) was significantly larger than that in exhalation (7.5 ± 4.6 %). Interfractional variations in inhalation (17.2 ± 18.5 %) were also significantly greater than those in exhalation (9.4 ± 10.0 %). Statistically significant differences were observed between patients in the supine position and those in the prone position in mean respiratory cycle, duty cycle, and intra-/interfractional variations. We quantified the characteristics of the respiratory curve based on a large number of respiratory data obtained during treatment. These results might be useful in improving the accuracy of respiratory-gated treatment.

  19. Evaluation of the Usefulness of the Respiratory Guidance System in the Respiratory Gating Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Yeong Cheol; Kim, Sun Myung; Do, Gyeong Min; Park, Geun Yong; Kim, Gun Oh; Kim, Young Bum [Dept. of Radiation Oncology, Guro Hospital, Korea Univeristy, Seoul (Korea, Republic of)

    2012-09-15

    The respiration is one of the most important factors in respiratory gating radiation therapy (RGRT). We have developed an unique respiratory guidance system using an audio-visual system in order to support and stabilize individual patient's respiration and evaluated the usefulness of this system. Seven patients received the RGRT at our clinic from June 2011 to April 2012. After breathing exercise standard deviations by the superficial contents of respiratory cycles and functions, and analyzed them to examine changes in their breathing before and with the audio-visual system, we measured their spontaneous respiration and their respiration with the audio-visual system respectively. With the measured data, we yielded after the therapy. The PTP (peak to peak) of the standard deviations of the free breathing, the audio guidance system, and the respiratory guidance system were 0.343, 0.148, and 0.078 respectively. The respiratory cycles were 0.645, 0.345, and 0.171 respectively and the superficial contents of the respiratory functions were 2.591, 1.008, and 0.877 respectively. The average values of the differences in the standard deviations among the whole patients at the CT room and therapy room were 0.425 for the PTP, 1.566 for the respiratory cycles, and 3.671 for the respiratory superficial contents. As for the standard deviations before and after the application of the PTP respiratory guidance system, that of the PTP was 0.265, that of the respiratory cycles was 0.474, and that of the respiratory superficial contents. The results of t-test of the values before and after free breathing and the audio-visual guidance system showed that the P-value of the PTP was 0.035, that of the cycles 0.009, and that of the respiratory superficial contents 0.010. The respiratory control could be one of the most important factors in the RGRT which determines the success or failure of a treatment. We were able to get more stable breathing with the audio-visual respiratory

  20. Evaluation of the Usefulness of the Respiratory Guidance System in the Respiratory Gating Radiation Therapy

    International Nuclear Information System (INIS)

    Lee, Yeong Cheol; Kim, Sun Myung; Do, Gyeong Min; Park, Geun Yong; Kim, Gun Oh; Kim, Young Bum

    2012-01-01

    The respiration is one of the most important factors in respiratory gating radiation therapy (RGRT). We have developed an unique respiratory guidance system using an audio-visual system in order to support and stabilize individual patient's respiration and evaluated the usefulness of this system. Seven patients received the RGRT at our clinic from June 2011 to April 2012. After breathing exercise standard deviations by the superficial contents of respiratory cycles and functions, and analyzed them to examine changes in their breathing before and with the audio-visual system, we measured their spontaneous respiration and their respiration with the audio-visual system respectively. With the measured data, we yielded after the therapy. The PTP (peak to peak) of the standard deviations of the free breathing, the audio guidance system, and the respiratory guidance system were 0.343, 0.148, and 0.078 respectively. The respiratory cycles were 0.645, 0.345, and 0.171 respectively and the superficial contents of the respiratory functions were 2.591, 1.008, and 0.877 respectively. The average values of the differences in the standard deviations among the whole patients at the CT room and therapy room were 0.425 for the PTP, 1.566 for the respiratory cycles, and 3.671 for the respiratory superficial contents. As for the standard deviations before and after the application of the PTP respiratory guidance system, that of the PTP was 0.265, that of the respiratory cycles was 0.474, and that of the respiratory superficial contents. The results of t-test of the values before and after free breathing and the audio-visual guidance system showed that the P-value of the PTP was 0.035, that of the cycles 0.009, and that of the respiratory superficial contents 0.010. The respiratory control could be one of the most important factors in the RGRT which determines the success or failure of a treatment. We were able to get more stable breathing with the audio-visual respiratory guidance

  1. Evaluation of space capacities of the respiratory muscles during hypokinesia

    Science.gov (United States)

    Baranov, V. M.; Aleksandrova, N. P.; Tikhonov, M. A.

    2005-08-01

    Nowdays, the phenomenon of physical performance degradation after a long period of motor restraint or microgravity is universally interpreted as a result of deconditioning of the cardiovascular system and anti- gravity skeletal muscles.Yet, deconditioning affects not only the skeletal but also respiratory muscles exhaustion of which by relative hypoventilation brings about hypercapnia, hypoxia and pulmonary acidosis conducive to the sensations of painful breathlessness impacting the capacity for physical work. It should be emphasized that these developments are little known in spite of their theoretical and practical significance; therefore, our purpose was to study the functional state and spare capacity of the respiratory muscles in laboratory animals (Wistar rats) following 3-wk tail-suspension.The experiment strengthened the hypothesis according to which simulation of the physiological effects of motor restraint and microgravity leads to fatigue and deconditioning of the respiratory muscles.

  2. Heliox reduces respiratory system resistance in respiratory syncytial virus induced respiratory failure

    NARCIS (Netherlands)

    Kneyber, Martin C. J.; van Heerde, Marc; Twisk, Jos W. R.; Plotz, Frans B.; Markhors, Dick G.

    2009-01-01

    Introduction Respiratory syncytial virus (RSV) lower respiratory tract disease is characterised by narrowing of the airways resulting in increased airway resistance, air-trapping and respiratory acidosis. These problems might be overcome using helium-oxygen gas mixture. However, the effect of

  3. Heliox reduces respiratory system resistance in respiratory syncytial virus induced respiratory failure

    NARCIS (Netherlands)

    Kneijber, M.C.J.; van Heerde, M.; Twisk, J.W.R.; Plotz, F.; Markhorst, D.G.

    2009-01-01

    Introduction: Respiratory syncytial virus (RSV) lower respiratory tract disease is characterised by narrowing of the airways resulting in increased airway resistance, air-trapping and respiratory acidosis. These problems might be overcome using helium-oxygen gas mixture. However, the effect of

  4. Respiratory problems in foals.

    Science.gov (United States)

    Beech, J

    1985-04-01

    Despite major advances in our knowledge and ability to treat respiratory diseases in neonatal foals, neonatal respiratory medicine is still in its infancy. It is hoped that this article may serve as a guideline for diagnosis and treatment. Specific antibiotic regimens and emergency procedures are covered in other articles in this symposium. Because management factors play a critical role in the pathogenesis of respiratory disease, education of clients as to their importance would help both prophylactically and therapeutically. The necessity of very careful monitoring of neonates, which is critical to early detection of disease, should be stressed. As respiratory diseases can be fulminant and rapidly fatal, it is imperative not to delay diagnosis and therapy. Thorough examination and implementation of appropriate diagnostic techniques, as well as prompt early referral to a more sophisticated facility when indicated, would prevent many deaths. Although sophisticated support systems are vital for survival of some of these foals, good basic intensive nursing care combined with selection of appropriate drug therapy very early in the course of the disease is all that many foals require and can significantly improve survival rates.

  5. Physical examination tests for the diagnosis of posterior cruciate ligament rupture: a systematic review.

    Science.gov (United States)

    Kopkow, Christian; Freiberg, Alice; Kirschner, Stephan; Seidler, Andreas; Schmitt, Jochen

    2013-11-01

    Systematic literature review. To summarize and evaluate research on the accuracy of physical examination tests for diagnosis of posterior cruciate ligament (PCL) tear. Rupture of the PCL is a severe knee injury that can lead to delayed rehabilitation, instability, or chronic knee pathologies. To our knowledge, there is currently no systematic review of studies on the diagnostic accuracy of clinical examination tests to evaluate the integrity of the PCL. A comprehensive systematic literature search was conducted in MEDLINE from 1946, Embase from 1974, and the Allied and Complementary Medicine Database from 1985 until April 30, 2012. Studies were considered eligible if they compared the results of physical examination tests performed in the context of a PCL physical examination to those of a reference standard (arthroscopy, arthrotomy, magnetic resonance imaging). Methodological quality assessment was performed by 2 independent reviewers using the revised version of the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. The search strategy revealed 1307 articles, of which 11 met the inclusion criteria for this review. In these studies, 11 different physical examination tests were identified. Due to differences in study types, different patient populations, and methodological quality, meta-analysis was not indicated. Presently, most physical examination tests have not been evaluated sufficiently enough to be confident in their ability to either confirm or rule out a PCL tear. The diagnostic accuracy of physical examination tests to assess the integrity of the PCL is largely unknown. There is a strong need for further research in this area. Level of Evidence Diagnosis, level 3a.

  6. Validity of Combining History Elements and Physical Examination Tests to Diagnose Patellofemoral Pain.

    Science.gov (United States)

    Décary, Simon; Frémont, Pierre; Pelletier, Bruno; Fallaha, Michel; Belzile, Sylvain; Martel-Pelletier, Johanne; Pelletier, Jean-Pierre; Feldman, Debbie; Sylvestre, Marie-Pierre; Vendittoli, Pascal-André; Desmeules, François

    2018-04-01

    To assess the validity of diagnostic clusters combining history elements and physical examination tests to diagnose or exclude patellofemoral pain (PFP). Prospective diagnostic study. Orthopedic outpatient clinics, family medicine clinics, and community-dwelling. Consecutive patients (N=279) consulting one of the participating orthopedic surgeons (n=3) or sport medicine physicians (n=2) for any knee complaint. Not applicable. History elements and physical examination tests were obtained by a trained physiotherapist blinded to the reference standard: a composite diagnosis including both physical examination tests and imaging results interpretation performed by an expert physician. Penalized logistic regression (least absolute shrinkage and selection operator) was used to identify history elements and physical examination tests associated with the diagnosis of PFP, and recursive partitioning was used to develop diagnostic clusters. Diagnostic accuracy measures including sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios with associated 95% confidence intervals (CIs) were calculated. Two hundred seventy-nine participants were evaluated, and 75 had a diagnosis of PFP (26.9%). Different combinations of history elements and physical examination tests including the age of participants, knee pain location, difficulty descending stairs, patellar facet palpation, and passive knee extension range of motion were associated with a diagnosis of PFP and used in clusters to accurately discriminate between individuals with PFP and individuals without PFP. Two diagnostic clusters developed to confirm the presence of PFP yielded a positive likelihood ratio of 8.7 (95% CI, 5.2-14.6) and 3 clusters to exclude PFP yielded a negative likelihood ratio of .12 (95% CI, .06-.27). Diagnostic clusters combining common history elements and physical examination tests that can accurately diagnose or exclude PFP compared to various knee

  7. Rationale for promoting physical activity among cancer survivors: literature review and epidemiologic examination.

    Science.gov (United States)

    Loprinzi, Paul D; Lee, Hyo

    2014-03-01

    To review the extant literature on the link between physical activity and health outcomes among cancer survivors; identify evidence-based strategies to promote physical activity among this population; and conduct an epidemiologic study based on gaps from the literature review, examining the association between physical activity and various biologic markers. The authors used PubMed and Google Scholar up to July 2013, as well as data from the 2003-2006 National Health and Nutrition Examination Survey for the empirical study. Studies were examined through a systematic review process. In the epidemiologic study, 227 adult cancer survivors wore an accelerometer for four days or longer, with biologic markers (e.g., cholesterol) assessed from a blood sample. The review study demonstrated that cancer survivors are relatively inactive, but physical activity may help to reduce the risk of cancer recurrence and cancer-related mortality, increase cancer treatment rates, reduce pain and other side effects associated with cancer treatment, and improve physical and mental health. The epidemiologic study showed that physical activity was associated with several understudied biomarkers (e.g., neutrophils, white blood cells) that are linked with cancer recurrence, cancer-related mortality, and other chronic diseases. Nurses are encouraged to promote physical activity in cancer survivors.

  8. Physical examination prior to initiating hormonal contraception: a systematic review.

    Science.gov (United States)

    Tepper, Naomi K; Curtis, Kathryn M; Steenland, Maria W; Marchbanks, Polly A

    2013-05-01

    Provision of contraception is often linked with physical examination, including clinical breast examination (CBE) and pelvic examination. This review was conducted to evaluate the evidence regarding outcomes among women with and without physical examination prior to initiating hormonal contraceptives. The PubMed database was searched from database inception through March 2012 for all peer-reviewed articles in any language concerning CBE and pelvic examination prior to initiating hormonal contraceptives. The quality of each study was assessed using the United States Preventive Services Task Force grading system. The search did not identify any evidence regarding outcomes among women screened versus not screened with CBE prior to initiation of hormonal contraceptives. The search identified two case-control studies of fair quality which compared women who did or did not undergo pelvic examination prior to initiating oral contraceptives (OCs) or depot medroxyprogesterone acetate (DMPA). No differences in risk factors for cervical neoplasia, incidence of sexually transmitted infections, incidence of abnormal Pap smears or incidence of abnormal wet mount findings were observed. Although women with breast cancer should not use hormonal contraceptives, there is little utility in screening prior to initiation, due to the low incidence of breast cancer and uncertain value of CBE among women of reproductive age. Two fair quality studies demonstrated no differences between women who did or did not undergo pelvic examination prior to initiating OCs or DMPA with respect to risk factors or clinical outcomes. In addition, pelvic examination is not likely to detect any conditions for which hormonal contraceptives would be unsafe. Published by Elsevier Inc.

  9. Physical design correlates of efficiency and safety in emergency departments: a qualitative examination.

    Science.gov (United States)

    Pati, Debajyoti; Harvey, Thomas E; Pati, Sipra

    2014-01-01

    The objective of this study was to explore and identify physical design correlates of safety and efficiency in emergency department (ED) operations. This study adopted an exploratory, multimeasure approach to (1) examine the interactions between ED operations and physical design at 4 sites and (2) identify domains of physical design decision-making that potentially influence efficiency and safety. Multidisciplinary gaming and semistructured interviews were conducted with stakeholders at each site. Study data suggest that 16 domains of physical design decisions influence safety, efficiency, or both. These include (1) entrance and patient waiting, (2) traffic management, (3) subwaiting or internal waiting areas, (4) triage, (5) examination/treatment area configuration, (6) examination/treatment area centralization versus decentralization, (7) examination/treatment room standardization, (8) adequate space, (9) nurse work space, (10) physician work space, (11) adjacencies and access, (12) equipment room, (13) psych room, (14) staff de-stressing room, (15) hallway width, and (16) results waiting area. Safety and efficiency from a physical environment perspective in ED design are mutually reinforcing concepts--enhancing efficiency bears positive implications for safety. Furthermore, safety and security emerged as correlated concepts, with security issues bearing implications for safety, thereby suggesting important associations between safety, security, and efficiency.

  10. Nanotechnology in respiratory medicine.

    Science.gov (United States)

    Omlor, Albert Joachim; Nguyen, Juliane; Bals, Robert; Dinh, Quoc Thai

    2015-05-29

    Like two sides of the same coin, nanotechnology can be both boon and bane for respiratory medicine. Nanomaterials open new ways in diagnostics and treatment of lung diseases. Nanoparticle based drug delivery systems can help against diseases such as lung cancer, tuberculosis, and pulmonary fibrosis. Moreover, nanoparticles can be loaded with DNA and act as vectors for gene therapy in diseases like cystic fibrosis. Even lung diagnostics with computer tomography (CT) or magnetic resonance imaging (MRI) profits from new nanoparticle based contrast agents. However, the risks of nanotechnology also have to be taken into consideration as engineered nanomaterials resemble natural fine dusts and fibers, which are known to be harmful for the respiratory system in many cases. Recent studies have shown that nanoparticles in the respiratory tract can influence the immune system, can create oxidative stress and even cause genotoxicity. Another important aspect to assess the safety of nanotechnology based products is the absorption of nanoparticles. It was demonstrated that the amount of pulmonary nanoparticle uptake not only depends on physical and chemical nanoparticle characteristics but also on the health status of the organism. The huge diversity in nanotechnology could revolutionize medicine but makes safety assessment a challenging task.

  11. Use of radiotelemetry to evaluate respiratory depression produced by chronic methadone administration.

    Science.gov (United States)

    Lewanowitsch, Tanya; White, Jason M; Irvine, Rodney J

    2004-01-26

    Illicit and therapeutic opioid administration can result in overdose due to opioid-induced respiratory depression. Research investigating the respiratory depressant effects of opioids has been limited due to difficulties associated with acquiring long-term respiratory data. This study examined the novel use of radiotelemetry to measure respiratory rate, heart rate, locomotor activity and blood pressure in rats treated chronically with methadone. Over 4 days of treatment, respiratory rate decreased, but partial tolerance appeared to develop during active (night) periods. Decreased heart rate was observed during the night periods and tolerance appeared to develop to this effect. Activity and blood pressure did not change with treatment. The effects of naloxone hydrochloride and naloxone methiodide administration on the methadone-treated rats were also examined and both antagonists increased respiratory rate and heart rate, with only naloxone hydrochloride producing significant increases in activity. Radiotelemetry offers a means of evaluating drug effects on respiratory rate continually in ambulatory, unstressed animals.

  12. [Detection of respiratory tract diseases among rural population during the team-work mass screening].

    Science.gov (United States)

    Abramson, E Z; Galkin, V B; Stepanova, G Ia

    1990-01-01

    A screening complex for the examination of the rural population has been worked out to detect bronchopulmonary pathology and form groups of risk for respiratory diseases. The complex of methods included compulsory questionnaires and ++fluoro-functional examination, spirometry if indicated and bacterial tests. Out of 1, 131 persons examined, 328 were found to have respiratory diseases. Chronic non-specific respiratory diseases were detected in 103 subjects, including 62 of them having obstructive bronchitis. A risk group developing chronic non-specific respiratory diseases, including 202 persons with disturbed ventilation activity of the lungs, post-tuberculous inadequate changes and other pathology. Pulmonary tuberculosis was registered in 7 subjects. The given data indicate the necessity of a complex examination of the population.

  13. The Enduring Value of the Physical Examination.

    Science.gov (United States)

    Zaman, Junaid A B

    2018-05-01

    This article focuses exclusively on physical examination (PE) in the context of clinical medicine, that is, the interaction between a health care provider and patient. In essence, there is not only benefit (value) to PE but also that it will last (endure) for some time. Both "enduring" and "value" are explored in more depth with respect to the future integration of PE into the clinical assessment of a patient and how its value extends well beyond current diagnostic/cost-based metrics. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

  14. Is there an agreement among the items of the Korean physical therapist licensing examination, learning objectives of class subjects, and physical therapists' job descriptions?

    Science.gov (United States)

    Kang, Min-Hyeok; Kwon, Oh-Yun; Kim, Yong-Wook; Kim, Ji-Won; Kim, Tae-Ho; Oh, Tae-Young; Weon, Jong-Hyuk; Lee, Tae-Sik; Oh, Jae-Seop

    2016-01-01

    To determine the agreement among the items of the Korean physical therapist licensing examination, learning objectives of class subjects, and physical therapists' job descriptions. The main tasks of physical therapists were classified, and university courses related to the main tasks were also classified. Frequency analysis was used to determine the proportions of credits for the classified courses out of the total credits of major subjects, exam items related to the classified courses out of the total number of exam items, and universities that offer courses related to the Korean physical therapist licensing examination among the surveyed universities. The proportions of credits for clinical decision making and physical therapy diagnosis-related courses out of the total number credits for major subjects at universities were relatively low (2.06% and 2.58%, respectively). Although the main tasks of physical therapists are related to diagnosis and evaluation, the proportion of physiotherapy intervention-related items (35%) was higher than that of examination and evaluation-related items (25%) on the Korean physical therapist licensing examination. The percentages of universities that offer physical therapy diagnosis and clinical decision making-related courses were 58.62% and 68.97%, respectively. Both the proportion of physiotherapy diagnosis and evaluation-related items on the Korean physical therapist licensing examination, and the number of subjects related to clinical decision making and physical therapy diagnosis in the physical therapy curriculum, should be increased to ensure that the examination items and physical therapy curriculum reflect the practical tasks of physical therapists.

  15. 20 CFR 718.104 - Report of physical examinations.

    Science.gov (United States)

    2010-04-01

    ... Section 718.104 Employees' Benefits EMPLOYMENT STANDARDS ADMINISTRATION, DEPARTMENT OF LABOR FEDERAL COAL...) The miner's medical and employment history; (2) All manifestations of chronic respiratory disease; (3... diagnostic techniques, such as a blood gas study. (b) In addition to the requirements of paragraph (a), a...

  16. Nicotine dependence matters: examining longitudinal association between smoking and physical activity among Canadian adults.

    Science.gov (United States)

    Azagba, Sunday; Asbridge, Mark

    2013-11-01

    A number of studies point to the inverse relationship between physical activity and smoking; however, none has examined the role of nicotine dependence in physical activity participation among smokers. This study examined whether levels of nicotine dependence modify the association between leisure time physical activity and smoking status. The study used longitudinal data on 6795 adults from the Canadian National Population Health Survey (2004-2010). Generalized estimating equations were used to examine the association between physical activity, smoking, and nicotine dependence. We found that nicotine dependent smokers were significantly less likely to be physically active compared to non-smokers. Specifically, using the Fagerstrom Test for Nicotine Dependence, nicotine dependent smokers (OR 0.65, 95% CI 0.55-0.76) were less likely to be physically active while no significant difference was found for non-dependent smokers (OR 0.90, 95% CI 0.80-1.02) compared to non-smokers. Nicotine dependence matters in shaping engagement in physical activity among daily smokers. Efforts directed at promoting smoking cessation through nicotine dependence treatment intervention may provide additional benefits to health and well-being through an increased participation in physical activity. © 2013.

  17. [Undernutrition in chronic respiratory diseases].

    Science.gov (United States)

    Zielonka, Tadeusz M; Hadzik-Błaszczyk, Małgorzata

    2015-01-01

    Respiratory diseases such as asthma, COPD, lung cancer, infections, including also tuberculosis constitute the most frequent diseases in the word. Undernutrition frequently accompanies these diseases. Early diagnosis of malnutrition and implementation of appropriate treatment is very important. A nutritional interview and anthropometric examinations, such as body mass index, fat free mass and fat mass are used to diagnose it. Nutritional therapy affects the course and prognosis of these diseases. Diet should be individually adjusted to the calculated caloric intake that increases during exacerbation of disease, because of increased respiratory effort. Too large supply of energy can cause increase metabolism, higher oxygen consumption and PaCO2 increase each dangerous for patients with respiratory insufficiency. Main source of carbohydrates for these patients should be products with low glycemic index and with high dietary fiber contents. Large meals should be avoided since they cause rapid satiety, abdominal discomfort and have negative impact on the work of the respiratory muscles, especially of the diaphragm. Dietary supplements can be used in case of ineffectiveness of diet or for the patients with severe undernutrition.

  18. The physical examination content of the Japanese National Health and Nutrition Survey: temporal changes.

    Science.gov (United States)

    Tanaka, Hisako; Imai, Shino; Nakade, Makiko; Imai, Eri; Takimoto, Hidemi

    2016-12-01

    Survey items of the Japan National Nutrition Survey (J-NNS) have changed over time. Several papers on dietary surveys have been published; however, to date, there are no in-depth papers regarding physical examinations. Therefore, we investigated changes in the survey items in the physical examinations performed in the J-NNS and the National Health and Nutrition Survey (NHNS), with the aim of incorporating useful data for future policy decisions. We summarized the description of physical examinations and marshalled the changes of survey items from the J-NNS and NHNS from 1946 to 2012. The physical examination is roughly classified into the following six components: some are relevant to anthropometric measurements, clinical measurements, physical symptoms, blood tests, lifestyle and medication by interview, and others. Items related to nutritional deficiency, such as anaemia and tendon reflex disappearance, and body weight measurements were collected during the early period, according to the instructions of the General Headquarters. From 1989, blood tests and measurement of physical activity were added, and serum total protein, total cholesterol, triglycerides, HDL-cholesterol, blood glucose, red blood corpuscles and haemoglobin measurements have been performed continuously for more than 20 years. This is the first report on the items of physical examination in the J-NNS and NHNS. Our research results provide basic information for the utilization of the J-NNS and NHNS, to researchers, clinicians or policy makers. Monitoring the current state correctly is essential for national health promotion, and also for improvement of the investigation methods to apply country-by-country comparisons.

  19. Association between physical activity and kidney function: National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Hawkins, Marquis S; Sevick, Mary Ann; Richardson, Caroline R; Fried, Linda F; Arena, Vincent C; Kriska, Andrea M

    2011-08-01

    Chronic kidney disease is a condition characterized by the deterioration of the kidney's ability to remove waste products from the body. Although treatments to slow the progression of the disease are available, chronic kidney disease may eventually lead to a complete loss of kidney function. Previous studies have shown that physical activities of moderate intensity may have renal benefits. Few studies have examined the effects of total movement on kidney function. The purpose of this study was to determine the association between time spent at all levels of physical activity intensity and sedentary behavior and kidney function. Data were obtained from the 2003-2004 and 2005-2006 National Health and Nutrition Examination Survey, a cross-sectional study of a complex, multistage probability sample of the US population. Physical activity was assessed using an accelerometer and questionnaire. Glomerular filtration rate (eGFR) was estimated using the Modification of Diet in Renal Disease study formula. To assess linear associations between levels of physical activity and sedentary behavior with log-transformed estimated GFR (eGFR), linear regression was used. In general, physical activity (light and total) was related to log eGFR in females and males. For females, the association between light and total physical activity with log eGFR was consistent regardless of diabetes status. For males, the association between light and total physical activity and log eGFR was only significant in males without diabetes. When examining the association between physical activity, measured objectively with an accelerometer, and kidney function, total and light physical activities were found to be positively associated with kidney function.

  20. Prevention and treatment of respiratory consequences induced by sulfur mustard in Iranian casualties

    Directory of Open Access Journals (Sweden)

    Seyed M Razavi

    2013-01-01

    Full Text Available Background: About 100,000 Iranian have been exposed to chemical weapons during Iraq-Iran conflict (1980-88. After being spent of more than two decades, still about 30,000 of them are under follow-up treatment. The main aim of this study was to review various preventive and therapeutic methods for injured patients with sulfur mustard in different phases. Methods: For gathering information, we have used the electronic databases including Scopus, Medline, ISI, IranMedex, Irandoc sites. According to this search strategy, 104 published articles associated to respiratory problems and among them 50 articles related to prevention and treatment of respiratory problems were found and reviewed. Results: There is not any curative treatment for sulfur mustard induced lung injuries, but some valuable experienced measures for prevention and palliative treatments are available. Some useful measures in acute phase include: Symptomatic management, oxygen supplementation, tracheostomy in laryngospasm, use of moist air, respiratory physical therapy, mucolytic agents and bronchodilators. In the chronic phases, these measures include: Periodic clinical examinations, administration of inhaled corticosteroids alone or with long-acting beta 2 agonists, use of antioxidants, magnesium ions, long term oxygen supplement, therapeutic bronchoscopy, laser therapy, and use of respiratory tract stents. Conclusions: Most treatments are symptomatic but using preventive points immediately after exposure could improve following outcomes.

  1. Time to Add a Fifth Pillar to Bedside Physical Examination: Inspection, Palpation, Percussion, Auscultation, and Insonation.

    Science.gov (United States)

    Narula, Jagat; Chandrashekhar, Y; Braunwald, Eugene

    2018-04-01

    Inspection, palpation, percussion, and auscultation have been the 4 pillars of clinical bedside medicine. Although these basic methods of physical examination have served us well, traditional bedside examination, for a number of reasons including diminishing interest and expertise, performs well less than what is required of a modern diagnostic strategy. Improving the performance of physical examination is vital given that it is crucial to guide diagnostic possibilities and further testing. Current efforts at improving physical examination skills during medical training have not been very successful, and incorporating appropriate technology at the bedside might improve its performance. Selective use of bedside ultrasound (or insonation) can be one such strategy that could be incorporated as the fifth component of the physical examination. Seeing pathology through imaging might improve interest in physical examination among trainees, and permit appropriate downstream testing and possibly superior decision making. Current ultrasound technology makes this feasible, and further miniaturization of ultrasound devices and reduced cost will allow for routine use at the bedside. It is time to have a wider debate and a possible consensus about updates required to enhance current paradigms of physical examination.

  2. Decreased respiratory symptoms in cannabis users who vaporize

    Directory of Open Access Journals (Sweden)

    Barnwell Sara

    2007-04-01

    Full Text Available Abstract Cannabis smoking can create respiratory problems. Vaporizers heat cannabis to release active cannabinoids, but remain cool enough to avoid the smoke and toxins associated with combustion. Vaporized cannabis should create fewer respiratory symptoms than smoked cannabis. We examined self-reported respiratory symptoms in participants who ranged in cigarette and cannabis use. Data from a large Internet sample revealed that the use of a vaporizer predicted fewer respiratory symptoms even when age, sex, cigarette smoking, and amount of cannabis used were taken into account. Age, sex, cigarettes, and amount of cannabis also had significant effects. The number of cigarettes smoked and amount of cannabis used interacted to create worse respiratory problems. A significant interaction revealed that the impact of a vaporizer was larger as the amount of cannabis used increased. These data suggest that the safety of cannabis can increase with the use of a vaporizer. Regular users of joints, blunts, pipes, and water pipes might decrease respiratory symptoms by switching to a vaporizer

  3. Food insecurity, vitamin D insufficiency and respiratory infections among Inuit children.

    Science.gov (United States)

    Tse, Sze Man; Weiler, Hope; Kovesi, Tom

    2016-01-01

    Food insecurity, vitamin D deficiency and lower respiratory tract infections are highly prevalent conditions among Inuit children. However, the relationship between these conditions has not been examined in this population. The objective of this study was to examine the relationship between food insecurity and severe respiratory infections before age 2 years and health centre visits for a respiratory problem in the past year. We also explored the relationship between serum vitamin D status and respiratory outcomes in this population. We included children aged 3-5 years who participated in a cross-sectional survey of the health of preschool Inuit children in Nunavut, Canada, from 2007 to 2008 (n=388). Parental reports of severe respiratory infections in the first 2 years of life and health care visits in the past 12 months were assessed through a questionnaire. Child and adult food security were assessed separately and serum 25-hydroxyvitamin D3 levels were measured in a subgroup of participants (n=279). Multivariate logistic regression was performed to assess the association between food security, vitamin D and each of the 2 respiratory outcomes. Child and adult food insecurity measures were not significantly associated with adverse respiratory outcomes. Household crowding [odds ratio (OR)=1.51, 95% confidence interval (CI) 1.09-2.09, p=0.01 for the child food security model] and higher birth weight (OR=1.21, 95% CI: 1.02-1.43, p=0.03) were associated with reported severe chest infections before age 2 years while increasing age was associated with decreased odds of reported health care visits for a respiratory problem (OR=0.66, 95% CI: 0.48-0.91, p=0.02). Neither vitamin D insufficiency nor deficiency was associated with these respiratory outcomes. Using a large cross-sectional survey of Inuit children, we found that household crowding, but not food security or vitamin D levels, was associated with adverse respiratory outcomes. Further studies are warranted to

  4. Examining the Pathways between Gratitude and Self-Rated Physical Health across Adulthood

    Science.gov (United States)

    Hill, Patrick L.; Allemand, Mathias; Roberts, Brent W.

    2012-01-01

    The current study examined whether dispositional gratitude predicts physical health among adults, and if so, whether this relationship occurs because grateful individuals lead healthier lives, either psychologically or physically. Specifically, we examined whether psychological health, healthy activities, and willingness to seek help for health concerns mediated the link between gratitude and self-reported physical health, as well as if these mediational pathways are moderated by age, in a broad sample of Swiss adults (N = 962, Mage = 52 years, age range: 19 to 84). Dispositional gratitude correlated positively with self-reported physical health, and this link was mediated by psychological health, healthy activities, and willingness to seek help for health concerns. However, the indirect effects for psychological health and healthy activities were stronger for older than younger adults. In other words, the mechanisms explaining why gratitude predicts health appear to differ across adulthood. PMID:23139438

  5. Recurrent Acute Respiratory Infections in Children: Effectiveness and Safety of Phytotherapy

    Directory of Open Access Journals (Sweden)

    V. P. Vavilova

    2015-01-01

    Full Text Available Recurrent respiratory infections in children lead to physical development disorders, formation of chronic nidi of infection, failure of adaptive mechanisms and degradation o immunobiological resisting barriers; this causes development of new diseases. Results of the presented non interventional clinical study confirm high safety profile and effectiveness of a therapeutic phytopreparation for recurrent respiratory infections. 

  6. Housing and respiratory health at older ages.

    Science.gov (United States)

    Webb, E; Blane, D; de Vries, Robert

    2013-03-01

    A large proportion of the population of England live in substandard housing. Previous research has suggested that poor-quality housing, particularly in terms of cold temperatures, mould, and damp, poses a health risk, particularly for older people. The present study aimed to examine the association between housing conditions and objectively measured respiratory health in a large general population sample of older people in England. Data on housing conditions, respiratory health and relevant covariates were obtained from the second wave of the English Longitudinal Study of Ageing. Multivariate regression methods were used to test the association between contemporary housing conditions and respiratory health while accounting for the potential effect of other factors; including social class, previous life-course housing conditions and childhood respiratory health. Older people who were in fuel poverty or who did not live in a home they owned had significantly worse respiratory health as measured by peak expiratory flow rates. After accounting for covariates, these factors had no effect on any other measures of respiratory health. Self-reported housing problems were not consistently associated with respiratory health. The housing conditions of older people in England, particularly those associated with fuel poverty and living in rented accommodation, may be harmful to some aspects of respiratory health. This has implications for upcoming UK government housing and energy policy decisions.

  7. Tests and measures used by specialist physical therapists when examining patients with stroke.

    Science.gov (United States)

    Andrews, A Williams; Folger, Stephen E; Norbet, Shannon E; Swift, Lindsay C

    2008-09-01

    Examination procedures preferred by physical therapists have not been documented either specifically or comprehensively. The purpose of this study was to determine which tests and measures are used most frequently by specialists in the examination of adults with stroke. Physical therapy specialists were identified as having geriatric or neurologic certification through the American Board of Physical Therapy Specialties. A request to participate in a Web-based survey was sent to 471 individuals in the American Physical Therapy Association's Directory of Certified Specialists. A comprehensive list of tests and measures was first derived from the Interactive Guide to Physical Therapist Practice. The list was finalized based on several exclusion criteria and the results of a pilot study. Subjects rated the frequency of use of 294 tests and measures with patients post-stroke on a Likert scale. The survey response rate was 31.7% (n = 128). The 50 most frequently used tests and measures were identified. The results of this study do not identify the tests and measures that clinicians should use, only those that the specialists use. Nevertheless, clinicians may want to consider tests and measurements frequently used by specialists when examining adults with stroke.

  8. Respiratory diseases among U.S. military personnel: countering emerging threats.

    OpenAIRE

    Gray, G. C.; Callahan, J. D.; Hawksworth, A. W.; Fisher, C. A.; Gaydos, J. C.

    1999-01-01

    Emerging respiratory disease agents, increased antibiotic resistance, and the loss of effective vaccines threaten to increase the incidence of respiratory disease in military personnel. We examine six respiratory pathogens (adenoviruses, influenza viruses, Streptococcus pneumoniae, Streptococcus pyogenes, Mycoplasma pneumoniae, and Bordetella pertussis) and review the impact of the diseases they cause, past efforts to control these diseases in U.S. military personnel, as well as current treat...

  9. [Disturbed respiratory cycle accompanying hypoxic-ischemic encephalopathy].

    Science.gov (United States)

    Saito, Yoshiaki; Masuko, Kaori; Kaneko, Kaori; Saito, Kazuyo; Chikumaru, Yuri; Iwamoto, Hiroko; Matsui, Akira; Kimura, Seiji

    2005-09-01

    We report the case of a 2-year-old boy who experienced total asphyxia at 4 months of age, and suffered abnormalities at specific phases of the respiratory cycle. The patient was bedridden due to severe tetraplegia and showed little response to external stimuli. He has been tube-fed since the initial asphyxia and a tracheotomy was performed after recurrent hypoxic episodes as a result of the respiratory dysfunction. Upon examination, his respiratory pattern was characterized by arrest during the inspiratory phase with a possible over-riding secondary inspiration. The respiratory pause at the inspiratory phase was markedly prolonged during an episode of pulmonary infection, resulting in recurrent cyanosis that necessitated artificial ventilation. The "second" inspiration typically occurred during the mid- or late-inspiratory phases, with this pattern often shown to be variable after epileptic seizures. The characteristic breathing of this patient suggested that difficulty in forming a normal respiratory cycle, other than during periods of hypoventilation or apnoea, could be a significant respiratory dysfunction following asphyxiation. Strategies for the management of such patients should be carefully designed after close observation of breathing patterns within the respiratory cycle, and with consideration for the influence of epileptic seizures and other inputs from somatic afferents.

  10. Predictors of Heavy Stethoscope Contamination Following a Physical Examination.

    Science.gov (United States)

    Tschopp, Clément; Schneider, Alexis; Longtin, Yves; Renzi, Gesuele; Schrenzel, Jacques; Pittet, Didier

    2016-06-01

    BACKGROUND The degree of bacterial contamination of stethoscopes can vary significantly following a physical examination. OBJECTIVE To conduct a prospective study to investigate the impact of various environmental and patient characteristics on stethoscope contamination. METHODS Following a standardized examination, the levels of bacterial contamination of 4 regions of the physicians' hands and 2 sections of the stethoscopes, and the presence of different pathogenic bacteria, were assessed. Predictors of heavy stethoscope contamination were identified through multivariate logistic regression. RESULTS In total, 392 surfaces were sampled following examination of 56 patients. The microorganisms most frequently recovered from hands and stethoscopes were Enterococcus spp. (29% and 20%, respectively) and Enterobacteriaceae (16% and 7%, respectively). Staphylococcus aureus (either methicillin susceptible or resistant), extended-spectrum β-lactamase-producing Enterobacteriaceae, and Acinetobacter baumannii were recovered from 4%-9% of the samples from either hands or stethoscopes. There was a correlation between the likelihood of recovering these pathogens from the stethoscopes vs from the physicians' hands (ρ=0.79; P=.04). The level of patient's skin contamination was an independent predictor of contamination of the stethoscope diaphragm (adjusted odds ratio [aOR], 1.001; P=.007) and tube (aOR, 1.001; P=.003). Male sex (aOR, 28.24; P=.01) and reception of a bed bath (aOR, 7.52; P=.048) were also independently associated with heavy tube contamination. CONCLUSIONS Stethoscope contamination following a single physical examination is not negligible and is associated with the level of contamination of the patient's skin. Prevention of pathogen dissemination is needed. Infect Control Hosp Epidemiol 2016;37:673-679.

  11. Development and validation of a musculoskeletal physical examination decision-making test for medical students.

    Science.gov (United States)

    Bishop, Julie Y; Awan, Hisham M; Rowley, David M; Nagel, Rollin W

    2013-01-01

    Despite a renewed emphasis among educators, musculoskeletal education is still lacking in medical school and residency training programs. We created a musculoskeletal multiple-choice physical examination decision-making test to assess competency and physical examination knowledge of our trainees. We developed a 20-question test in musculoskeletal physical examination decision-making test with content that most medical students and orthopedic residents should know. All questions were reviewed by ratings of US orthopedic chairmen. It was administered to postgraduate year 2 to 5 orthopedic residents and 2 groups of medical students: 1 group immediately after their 3-week musculoskeletal course and the other 1 year after the musculoskeletal course completion. We hypothesized that residents would score highest, medical students 1 year post-musculoskeletal training lowest, and students immediately post-musculoskeletal training midrange. We administered an established cognitive knowledge test to compare student knowledge base as we expected the scores to correlate. Academic medical center in the Midwestern United States. Orthopedic residents, chairmen, and medical students. Fifty-four orthopedic chairmen (54 of 110 or 49%) responded to our survey, rating a mean overall question importance of 7.12 (0 = Not Important; 5 = Important; 10 = Very Important). Mean physical examination decision-making scores were 89% for residents, 77% for immediate post-musculoskeletal trained medical students, and 59% 1 year post-musculoskeletal trained medical students (F = 42.07, pphysical examination decision-making test was found to be internally consistent (Kuder-Richardson Formula 20 = 0.69). The musculoskeletal cognitive knowledge test was 78% for immediate post-musculoskeletal trained students and 71% for the 1 year post-musculoskeletal trained students. The student physical examination and cognitive knowledge scores were correlated (r = 0.54, pphysical examination decision-making test

  12. Childhood asthma and physical activity

    DEFF Research Database (Denmark)

    Lochte, Lene; Nielsen, Kim G; Petersen, Poul Erik

    2016-01-01

    BACKGROUND: Childhood asthma is a global problem affecting the respiratory health of children. Physical activity (PA) plays a role in the relationship between asthma and respiratory health. We hypothesized that a low level of PA would be associated with asthma in children and adolescents. The obj......BACKGROUND: Childhood asthma is a global problem affecting the respiratory health of children. Physical activity (PA) plays a role in the relationship between asthma and respiratory health. We hypothesized that a low level of PA would be associated with asthma in children and adolescents......; however, there was some heterogeneity among the studies. This review reveals a critical need for future longitudinal assessments of low PA, its mechanisms, and its implications for incident asthma in children. The systematic review was prospectively registered at PROSPERO (registration number: CRD...

  13. Necessity of introducing postencounter note describing history and physical examination at clinical performance examination in Korea.

    Science.gov (United States)

    Kim, Jonghoon

    2014-06-01

    Information gathering ability had been evaluated mainly via checklists in clinical performance examinations (CPX). But, it is not proved yet if students write the information correctly in postencounter note (PN), although they asked questions or performed physical examinations (PE) about the information when they interacted with standardized patients in CPX. This study addressed the necessity of introducing PN to evaluate the ability in CPX. After patient encounters, students were instructed to write the findings of history taking and physical examination that they considered as important information in approaching the patient's problems in PN. PNs were scored using answer keys selected from checklist items, which were considered to be recorded in PN by CPX experts. PNs of six CPX cases from 54 students were analyzed. Correlation coefficients between the key-checklist scores and PN scores of six cases were moderate to high (0.52 to 0.79). However, students frequently neglected some cardinal features of chief complains, pertinent findings of past/social history and PE, and pertinent negative findings of associated symptoms in PNs, which were checked as 'done' in the keys of checklists. It is necessary to introduce PN in CPX to evaluate the students' ability of synthesis and integration of patient information.

  14. Multidrug-resistant bacteria infection and nursing quality management application in the department of physical examination.

    Science.gov (United States)

    Xu, Li; Luo, Qiang; Chen, Liangzhen; Jiao, Lingmei

    2017-09-01

    The main problem of clinical prevention and control of multi drug resistant bacteria infection is to strengthen the monitoring of pathogenic bacteria spectrum, this study research on the multi drug-resistant bacteria infection and nursing quality management application in the department of physical examination. The results of this study showed that the number of patients with multiple drug resistant infections showed an increasing trend. Therefore, once the patients with multiple drug-resistant bacteria infection are found, the prevention and control of the patients with multiple drug-resistant bacteria should be strictly followed, and the patient's medication care should be highly valued. Also, the nurses need to be classified based on the knowledge and skill characteristics of the nurses in the department of physical examination, and compare the nursing effect before and after classification and grouping. The physicians and individuals receiving physical examinations in the department of physical examination had a higher degree of satisfaction for nursing effect after classification compared with those before classification. Classification and grouping management helps improve the nursing quality and overall quality of the nurses in the department of physical examination.

  15. Respiratory syncytial virus neutralizing antibodies in cord blood, respiratory syncytial virus hospitalization, and recurrent wheeze

    DEFF Research Database (Denmark)

    Stensballe, Lone Graff; Ravn, Henrik; Kristensen, Kim

    2008-01-01

    BACKGROUND: Respiratory syncytial virus (RSV) hospitalization is associated with wheeze. OBJECTIVE: To examine the influence of maternally derived RSV neutralizing antibodies in cord blood on RSV hospitalization and recurrent wheeze in infancy. METHODS: Among children from the Danish National Birth...

  16. Respiratory acidosis

    Science.gov (United States)

    Ventilatory failure; Respiratory failure; Acidosis - respiratory ... Causes of respiratory acidosis include: Diseases of the airways (such as asthma and COPD ) Diseases of the lung tissue (such as ...

  17. Spirometry filters can be used to detect exhaled respiratory viruses.

    Science.gov (United States)

    Mitchell, Alicia B; Mourad, Bassel; Tovey, Euan; Buddle, Lachlan; Peters, Matthew; Morgan, Lucy; Oliver, Brian G

    2016-09-26

    Respiratory viruses are very common in the community and contribute to the burden of illness for patients with chronic respiratory diseases, including acute exacerbations. Traditional sampling methods are invasive and problematic to repeat. Accordingly, we explored whether respiratory viruses could be isolated from disposable spirometry filters and whether detection of viruses in this context represented presence in the upper or lower respiratory tract. Discovery (n  =  53) and validation (n  =  49) cohorts were recruited from a hospital outpatient department during two different time periods. Spirometry mouthpiece filters were collected from all participants. Respiratory secretions were sampled from the upper and lower respiratory tract by nasal washing (NW), sputum, and bronchoalveolar lavage (BAL). All samples were examined using RT-PCR to identify a panel of respiratory viruses (rhinovirus, respiratory syncytial virus, influenza A, influenza B, parainfluenza virus 1, 2 & 3, and human metapneumovirus). Rhinovirus was quantified using qPCR. Paired filter-NW samples (n  =  29), filter-sputum samples (n  =  24), filter-BAL samples (n  =  39) and filter-NW-BAL samples (n  =  10) provided a range of comparisons. At least one virus was detected in any sample in 85% of participants in the discovery cohort versus 45% in the validation cohort. Overall, 72% of viruses identified in the paired comparator method matched those detected in spirometry filters. There was a high correlation between viruses identified in spirometry filters compared with viruses identified in both the upper and lower respiratory tract using traditional sampling methods. Our results suggest that examination of spirometry filters may be a novel and inexpensive sampling method for the presence of respiratory viruses in exhaled breath.

  18. Dosimetry of the respiratory tract

    International Nuclear Information System (INIS)

    Roy, M.

    1996-01-01

    A new dosimetric model of the human respiratory tract has been recently recommended by the International Commission on Radiological Protection, in ICRP Publication 66. This model was intended to update the previous lung model of the Task Group on Lung Dynamics that was adopted by ICRP in Publication 30. With this aim, extensive reviews of the available knowledge were made for anatomy and physiology of the respiratory tract and for deposition, clearance and biological effects of inhaled radionuclides. Finally, expanded dosimetry requirements resulted in a widely different approach from the former model. The main features of the new model are the followings: instead of calculating the average dose to the total mass of blood filled lung, the model takes account of differences in radiosensitivity of the venous respiratory tract tissues. It applies not only to adult workers but also to all members of the population, and provides reference values for children aged 3 months, 1, 5, 10, and 15 years, and adults. Deposition modelling of airborne gases and aerosols associates age dependent breathing rates, airway dimensions and physical activity, to particle size, density and chemical form of inhaled material. Clearance results of competition between mechanical transport clearance and absorption to blood. At each step of the calculation, adjustment guidance is provided to account for use of exact values of particle sizes and specific dissolution rates of inhaled material in order to calculate their own parameter of retention in the airways, and to assess accurately doses to the respiratory tract. Possible influence of smoking, of respiratory tract diseases and of eventual exposure to airborne toxicants is also addressed. (author)

  19. Upper Respiratory Tract Diseases in Athletes in Different Sports Disciplines.

    Science.gov (United States)

    Gałązka-Franta, Anna; Jura-Szołtys, Edyta; Smółka, Wojciech; Gawlik, Radosław

    2016-12-01

    Upper respiratory tract diseases in athletes are a very common medical problem. Training conditions in different sports disciplines increase the risk of upper respiratory disease. Epidemiological evidence suggests that heavy acute or chronic exercise is related to an increased incidence of upper respiratory tract infections in athletes. Regular physical exercise at high intensity may lead to transient immunosuppression due to high prevalence of allergic diseases in athletes. Regardless of the cause they can exclude athletes from the training program and significantly impair their performance. In the present work, the most common upper respiratory tract diseases in athletes taking into account the disciplines in which they most often occur were presented. The focus was laid on symptoms, diagnostic methods and pharmacotherapy. Moreover, preventive procedures which can help reduce the occurrence of upper respiratory tract disease in athletes were presented. Management according to anti-doping rules, criteria for return to training and competition as an important issues of athlete's health were discussed.

  20. Content analysis of physical examination templates in electronic health records using SNOMED CT.

    Science.gov (United States)

    Gøeg, Kirstine Rosenbeck; Chen, Rong; Højen, Anne Randorff; Elberg, Pia

    2014-10-01

    Most electronic health record (EHR) systems are built on proprietary information models and terminology, which makes achieving semantic interoperability a challenge. Solving interoperability problems requires well-defined standards. In contrast, the need to support clinical work practice requires a local customization of EHR systems. Consequently, contrasting goals may be evident in EHR template design because customization means that local EHR organizations can define their own templates, whereas standardization implies consensus at some level. To explore the complexity of balancing these two goals, this study analyzes the differences and similarities between templates in use today. A similarity analysis was developed on the basis of SNOMED CT. The analysis was performed on four physical examination templates from Denmark and Sweden. The semantic relationships in SNOMED CT were used to quantify similarities and differences. Moreover, the analysis used these identified similarities to investigate the common content of a physical examination template. The analysis showed that there were both similarities and differences in physical examination templates, and the size of the templates varied from 18 to 49 fields. In the SNOMED CT analysis, exact matches and terminology similarities were represented in all template pairs. The number of exact matches ranged from 7 to 24. Moreover, the number of unrelated fields differed a lot from 1/18 to 22/35. Cross-country comparisons tended to have more unrelated content than within-country comparisons. On the basis of identified similarities, it was possible to define the common content of a physical examination. Nevertheless, a complete view on the physical examination required the inclusion of both exact matches and terminology similarities. This study revealed that a core set of items representing the physical examination templates can be generated when the analysis takes into account not only exact matches but also terminology

  1. The risk of X-ray examinations of the lungs in neonates

    DEFF Research Database (Denmark)

    Arrøe, M

    1991-01-01

    X-ray examinations of the lungs is an important element in the evaluation of the neonates and their respiratory function. It is often necessary to perform a large number of X-ray examinations depending upon the infant's birthweight, gestational age and respiratory problems. To estimate the risk o....... It is concluded, that even using the latest increased risk factors, the radiation risk of repeated X-ray examinations of the chest in prematures will be very low considering the benefit for the infant.......X-ray examinations of the lungs is an important element in the evaluation of the neonates and their respiratory function. It is often necessary to perform a large number of X-ray examinations depending upon the infant's birthweight, gestational age and respiratory problems. To estimate the risk...

  2. Food insecurity, vitamin D insufficiency and respiratory infections among Inuit children

    Directory of Open Access Journals (Sweden)

    Sze Man Tse

    2016-02-01

    Full Text Available Background: Food insecurity, vitamin D deficiency and lower respiratory tract infections are highly prevalent conditions among Inuit children. However, the relationship between these conditions has not been examined in this population. Objective: The objective of this study was to examine the relationship between food insecurity and severe respiratory infections before age 2 years and health centre visits for a respiratory problem in the past year. We also explored the relationship between serum vitamin D status and respiratory outcomes in this population. Design: We included children aged 3–5 years who participated in a cross-sectional survey of the health of preschool Inuit children in Nunavut, Canada, from 2007 to 2008 (n=388. Parental reports of severe respiratory infections in the first 2 years of life and health care visits in the past 12 months were assessed through a questionnaire. Child and adult food security were assessed separately and serum 25-hydroxyvitamin D3 levels were measured in a subgroup of participants (n=279. Multivariate logistic regression was performed to assess the association between food security, vitamin D and each of the 2 respiratory outcomes. Results: Child and adult food insecurity measures were not significantly associated with adverse respiratory outcomes. Household crowding [odds ratio (OR=1.51, 95% confidence interval (CI 1.09–2.09, p=0.01 for the child food security model] and higher birth weight (OR=1.21, 95% CI: 1.02–1.43, p=0.03 were associated with reported severe chest infections before age 2 years while increasing age was associated with decreased odds of reported health care visits for a respiratory problem (OR=0.66, 95% CI: 0.48–0.91, p=0.02. Neither vitamin D insufficiency nor deficiency was associated with these respiratory outcomes. Conclusions: Using a large cross-sectional survey of Inuit children, we found that household crowding, but not food security or vitamin D levels, was

  3. Gene editing as a promising approach for respiratory diseases.

    Science.gov (United States)

    Bai, Yichun; Liu, Yang; Su, Zhenlei; Ma, Yana; Ren, Chonghua; Zhao, Runzhen; Ji, Hong-Long

    2018-03-01

    Respiratory diseases, which are leading causes of mortality and morbidity in the world, are dysfunctions of the nasopharynx, the trachea, the bronchus, the lung and the pleural cavity. Symptoms of chronic respiratory diseases, such as cough, sneezing and difficulty breathing, may seriously affect the productivity, sleep quality and physical and mental well-being of patients, and patients with acute respiratory diseases may have difficulty breathing, anoxia and even life-threatening respiratory failure. Respiratory diseases are generally heterogeneous, with multifaceted causes including smoking, ageing, air pollution, infection and gene mutations. Clinically, a single pulmonary disease can exhibit more than one phenotype or coexist with multiple organ disorders. To correct abnormal function or repair injured respiratory tissues, one of the most promising techniques is to correct mutated genes by gene editing, as some gene mutations have been clearly demonstrated to be associated with genetic or heterogeneous respiratory diseases. Zinc finger nucleases (ZFN), transcription activator-like effector nucleases (TALEN) and clustered regulatory interspaced short palindromic repeats/CRISPR-associated protein 9 (CRISPR/Cas9) systems are three innovative gene editing technologies developed recently. In this short review, we have summarised the structure and operating principles of the ZFNs, TALENs and CRISPR/Cas9 systems and their preclinical and clinical applications in respiratory diseases. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  4. Asymptomatic tracheal MALT lymphoma discovered on spirometric findings presenting with elevated respiratory resistance.

    Science.gov (United States)

    Kadota, Naoki; Shinohara, Tsutomu; Machida, Hisanori; Nakanishi, Hirofumi; Suehiro, Fumie; Toda, Hiroko; Yoshino, Tadashi; Ogushi, Fumitaka

    2015-06-06

    Central airway obstruction (CAO) may be caused by various etiologies. However, conventional chest X-rays are rarely diagnostic for patients with CAO. We here described a 64-year-old asymptomatic female with tracheal mucosa-associated lymphoid tissue lymphoma discovered on spirometric findings during a complete physical examination. The plateau of forced expiratory flow was consistent with CAO. A decreased peak expiratory flow rate was noted at least 3 years before the diagnosis, and was attributed to an insufficient effort by the patient. Impulse oscillometric measurements, which were taken during quiet breathing and were effort-independent, suggested elevated respiratory resistance. These abnormalities completely disappeared after radiation therapy. The addition of impulse oscillometry to spirometry may be useful for screening CAO in routine health examinations.

  5. Influence of the workplace on learning physical examination skills.

    Science.gov (United States)

    Duvivier, Robbert; Stalmeijer, Renée; van Dalen, Jan; van der Vleuten, Cees; Scherpbier, Albert

    2014-03-28

    Hospital clerkships are considered crucial for acquiring competencies such as diagnostic reasoning and clinical skills. The actual learning process in the hospital remains poorly understood. This study investigates how students learn clinical skills in workplaces and factors affecting this. Six focus group sessions with 32 students in Internal Medicine rotation (4-9 students per group; sessions 80-90 minutes). Verbatim transcripts were analysed by emerging themes and coded independently by three researchers followed by constant comparison and axial coding. Students report to learn the systematics of the physical examination, gain agility and become able to recognise pathological signs. The learning process combines working alongside others and working independently with increasing responsibility for patient care. Helpful behaviour includes making findings explicit through patient files or during observation, feedback by abnormal findings and taking initiative. Factors affecting the process negatively include lack of supervision, uncertainty about tasks and expectations, and social context such as hierarchy of learners and perceived learning environment. Although individual student experiences vary greatly between different hospitals, it seems that proactivity and participation are central drivers for learning. These results can improve the quality of existing programmes and help design new ways to learn physical examination skills.

  6. History and physical examination of hip injuries in elderly adults.

    Science.gov (United States)

    Hamedan Al Maqbali, Mohammed Abdullah

    2014-01-01

    Hip fracture is the most common injury occurring to elderly people and is associated with restrictions of the activities of the patients themselves. The discovery of a hip fracture can be the beginning of a complex journey of care, from initial diagnosis, through operational procedures to rehabilitation. The patient's history and physical examination form the basis of the diagnosis and monitoring of elderly patients with hip problems and dictate the appropriate treatment strategy to be implemented. The aim of this study is to discuss the different diagnoses of hip pain in a case study of an elderly woman who initially complained of pain in her right knee following a fall at home. It shows that musculoskeletal physical examination determined the management of the hip fracture that was found to be present. In addition, the aim of this article is to review diagnostic tests such as radiographs and recommend appropriate management and treatment of hip fractures in elderly patients.

  7. Static respiratory muscle work during immersion with positive and negative respiratory loading.

    Science.gov (United States)

    Taylor, N A; Morrison, J B

    1999-10-01

    Upright immersion imposes a pressure imbalance across the thorax. This study examined the effects of air-delivery pressure on inspiratory muscle work during upright immersion. Eight subjects performed respiratory pressure-volume relaxation maneuvers while seated in air (control) and during immersion. Hydrostatic, respiratory elastic (lung and chest wall), and resultant static respiratory muscle work components were computed. During immersion, the effects of four air-delivery pressures were evaluated: mouth pressure (uncompensated); the pressure at the lung centroid (PL,c); and at PL,c +/-0.98 kPa. When breathing at pressures less than the PL,c, subjects generally defended an expiratory reserve volume (ERV) greater than the immersed relaxation volume, minus residual volume, resulting in additional inspiratory muscle work. The resultant static inspiratory muscle work, computed over a 1-liter tidal volume above the ERV, increased from 0.23 J. l(-1), when subjects were breathing at PL,c, to 0.83 J. l(-1) at PL,c -0.98 kPa (P work was minimal. When breathing at PL,c +0.98 kPa, subjects adopted an ERV less than the immersed relaxation volume, minus residual volume, resulting in 0.36 J. l(-1) of expiratory muscle work. Thus static inspiratory muscle work varied with respiratory loading, whereas PL,c air supply minimized this work during upright immersion, restoring lung-tissue, chest-wall, and static muscle work to levels obtained in the control state.

  8. Respiratory alkalosis

    Science.gov (United States)

    Alkalosis - respiratory ... leads to shortness of breath can also cause respiratory alkalosis (such as pulmonary embolism and asthma). ... Treatment is aimed at the condition that causes respiratory alkalosis. Breathing into a paper bag -- or using ...

  9. Ultrasound Findings on Hands and Wrists of Patients with Systemic Lupus Erythematosus: Relationship with Physical Examination.

    Science.gov (United States)

    Lins, Carolina Freitas; Lima de Sá Ribeiro, Daniel; Dourado Santos, Willer Gonçalves; Rosa, Genevievi; Machicado, Viviane; Pedreira, Ana Luisa; Pimenta da Fonseca, Emanuela; Mota Duque Sousa, Anna Paula; Rodrigues Silva, Carla Baleeiro; Matos, Marcos Antonio Almeida; Santiago, Mittermayer Barreto

    2017-09-01

    Diagnosis of synovitis/tenosynovitis by physical examination can be difficult. Ultrasound (US) can be an effective tool for the evaluation of joint involvement in systemic lupus erythematosus (SLE). This study will describe musculoskeletal findings by US in SLE patients and the evaluation of their correlation with physical examination. SLE patients underwent clinical/sonographic evaluation of hand/wrists. In total, 896 joints were evaluated: at least 1 change on physical examination was found in 136 joints and at least 1 US abnormality was found in 65 of 896 joints. Out of the 65 joints with US changes, only 13 had findings on physical examination. Conversely, 111 joints had tenderness on physical examination with no sonographic abnormalities. Tenosynovitis was statistically significant more frequently with joint edema (41%) (p = 0.0003). US can detect musculoskeletal changes in only a minority of symptomatic SLE patients. Clinical findings may be related to some reasons that cannot be explained using US. Copyright © 2017 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  10. Diagnostic accuracy of scapular physical examination tests for shoulder disorders: a systematic review.

    Science.gov (United States)

    Wright, Alexis A; Wassinger, Craig A; Frank, Mason; Michener, Lori A; Hegedus, Eric J

    2013-09-01

    To systematically review and critique the evidence regarding the diagnostic accuracy of physical examination tests for the scapula in patients with shoulder disorders. A systematic, computerised literature search of PubMED, EMBASE, CINAHL and the Cochrane Library databases (from database inception through January 2012) using keywords related to diagnostic accuracy of physical examination tests of the scapula. The Quality Assessment of Diagnostic Accuracy Studies tool was used to critique the quality of each paper. Eight articles met the inclusion criteria; three were considered to be of high quality. Of the three high-quality studies, two were in reference to a 'diagnosis' of shoulder pain. Only one high-quality article referenced specific shoulder pathology of acromioclavicular dislocation with reported sensitivity of 71% and 41% for the scapular dyskinesis and SICK scapula test, respectively. Overall, no physical examination test of the scapula was found to be useful in differentially diagnosing pathologies of the shoulder.

  11. Physical Examination-Indicated Cerclage: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Ehsanipoor, Robert M; Seligman, Neil S; Saccone, Gabriele; Szymanski, Linda M; Wissinger, Christina; Werner, Erika F; Berghella, Vincenzo

    2015-07-01

    To estimate the effectiveness of physical examination-indicated cerclage in the setting of second-trimester cervical dilatation by systematic review and meta-analysis of published studies. We searched MEDLINE, EMBASE, Scopus, ClinicalTrials.gov, Web of Science, and the Cochrane Library for studies published between 1966 and 2014 that evaluated cervical cerclage for the treatment of cervical insufficiency. The search yielded 6,314 citations. We included cohort studies and randomized controlled trials comparing cerclage placement with expectant management of women with cervical dilatation between 14 and 27 weeks of gestation. Two investigators independently reviewed each citation for inclusion or exclusion and discordant decisions were arbitrated by a third reviewer. Summary estimates were reported as the mean difference and 95% confidence interval (CI) for continuous variables or relative risk and with 95% CI for dichotomous outcomes. Fixed- and random-effects meta-analysis was used, depending on heterogeneity. Ten studies met inclusion criteria and were included in the final analysis. One was a randomized controlled trial, two were prospective cohort studies, and the remaining seven were retrospective cohort studies. Of the 757 women, 485 (64%) underwent physical examination-indicated cerclage placement and 272 (36%) were expectantly managed. Cerclage was associated with increased neonatal survival (71% compared with 43%; relative risk 1.65, 95% CI 1.19-2.28) and prolongation of pregnancy (mean difference 33.98 days, 95% CI 17.88-50.08). Physical examination-indicated cerclage is associated with a significant increase in neonatal survival and prolongation of pregnancy of approximately 1 month when compared with no such cerclage. The strength of this conclusion is limited by the potential for bias in the included studies.

  12. Respiratory syncytial virus (RSV) pneumonia in a southern muriqui (Brachyteles arachnoides).

    Science.gov (United States)

    Santos, S V; Strefezzi, R F; Pissinatti, A; Takakura, C F H; Kanamura, C; Duarte, M I S; Catão-Dias, J L

    2012-12-01

    An adult male Brachyteles arachanoides, kept in captivity since 1990, was found dead without apparent clinical evidence. Necropsy report, histopathology, immunohistochemistry, and ultrastructural examination were conducted. Pulmonary syncytial cells were positive for respiratory syncytial virus (RSV), and ultrastructural examination revealed viral particles inside macrophages compatible with the Paramyxoviridae family. Muriquis are susceptible to RSV pneumonia followed by respiratory distress syndrome and death. © 2012 John Wiley & Sons A/S.

  13. Examining the relation between respiratory sinus arrhythmia and depressive symptoms in emerging adults: A longitudinal study.

    Science.gov (United States)

    Yaptangco, Mona; Crowell, Sheila E; Baucom, Brian R; Bride, Daniel L; Hansen, Erik J

    2015-09-01

    Major depressive disorder (MDD) is a debilitating and prevalent disorder associated with lower quality of life and substantial economic burden. Recently, there has been strong interest in respiratory sinus arrhythmia (RSA) as a biological predictor of later depression. Theoretical work suggests that higher resting RSA indexes physiological flexibility and better emotion regulation whereas lower RSA may mark vulnerability for psychopathology. However, empirical findings have varied. This study examined whether lower resting RSA predicted later depressive symptoms in a sample of healthy young adults across one year (n=185). Results indicate that year one (Y1) resting RSA predicted Y2 depressive symptoms. This finding remained significant when accounting for the stability of RSA and depressive symptoms across both time points and when including trait anxiety, body mass index, and medication use in statistical models. Findings provide further support for RSA as a promising biological marker for understanding and predicting depressive symptoms. Copyright © 2015 Elsevier B.V. All rights reserved.

  14. Differences in baseline factors and survival between normocapnia, compensated respiratory acidosis and decompensated respiratory acidosis in COPD exacerbation: A pilot study.

    Science.gov (United States)

    Lun, Chung-Tat; Tsui, Miranda S N; Cheng, Suet-Lai; Chan, Veronica L; Leung, Wah-Shing; Cheung, Alice P S; Chu, Chung-Ming

    2016-01-01

    Patients with chronic obstructive pulmonary disease (COPD) experiencing acute exacerbation (AE-COPD) with decompensated respiratory acidosis are known to have poor outcomes in terms of recurrent respiratory failure and death. However, the outcomes of AE-COPD patients with compensated respiratory acidosis are not known. We performed a 1-year prospective, single-centre, cohort study in patients surviving the index admission for AE-COPD to compare baseline factors between groups with normocapnia, compensated respiratory acidosis and decompensated respiratory acidosis. Survival analysis was done to examine time to readmissions, life-threatening events and death. A total of 250 patients fulfilling the inclusion and exclusion criteria were recruited and 245 patients were analysed. Compared with normocapnia, both compensated and decompensated respiratory acidosis are associated with lower FEV1 % (P respiratory acidosis, there was no difference in FEV1 (% predicted) (P = 0.15), GOLD stage (P = 0.091), BODE index (P = 0.158) or time to life-threatening events (P = 0.301). High PaCO2 level (P = 0.002) and previous use of non-invasive ventilation (NIV) in acute setting (P respiratory acidosis are associated with poorer lung function and higher risk of future life-threatening events. High PaCO2 level and past history of NIV use in acute settings were predictive factors for future life-threatening events. Compensated respiratory acidosis warrants special attention and optimization of medical therapy as it poses risk of life-threatening events. © 2015 Asian Pacific Society of Respirology.

  15. Ability to work in anaerobic condition is associated with physical performance on the six-minute walk test in older patients receiving cardiac rehabilitation.

    Science.gov (United States)

    Pasquini, Guido; Vannetti, Federica; Molino-Lova, Raffaele

    2015-05-01

    During maximal incremental exercise, the ability to work in the anaerobic condition, expressed by the respiratory exchange ratio, is associated with physical performance. Further, peak respiratory exchange ratio is regarded as the best non-invasive measure of a patient's actual exercise effort. This study examined whether ability to work in the anaerobic condition is also associated with physical performance in submaximal constant work rate exercise. A total of 75 older patients (51 men, 24 women), mean age 71.1 years (standard deviation 6.7 years), who had recently undergone cardiac surgery, performed cardiopulmonary exercise testing in a 6-min walk test before and after rehabilitation. The distance walked, steady-state oxygen uptake, carbon dioxide output and respiratory exchange ratio increased significantly after rehabilitation (p work in the anaerobic condition is associated with physical performance in submaximal constant work rate exercises. Thus the steady-state respiratory exchange ratio might be regarded as a measure of the patient's actual exercise effort. This information may prove useful in customizing exercise prescription and assessing the effects of rehabilitation.

  16. Interferon therapy of acute respiratory viral infections in children

    Directory of Open Access Journals (Sweden)

    A.E. Abaturov

    2017-04-01

    Full Text Available The purpose of our study was to evaluate the efficacy and tolerability of nasal spray Laferobionum® (100,000 IU/ml in children with acute respiratory viral infections. Materials and methods. The study included 84 children aged 12 to 18 years. Children of the main group (42 persons received Laferobionum® spray in addition to the standard treatment for acute respiratory viral infections. The drug was administered to children of 12–14 years for 2 spray doses in each nasal passage 4–5 times a day at regular intervals (with the exception of sleep time, children aged 14–18 years received 3 spray-doses per each nasal passage 5–6 times a day at regular intervals (excluding sleep time. The course of treatment for all subjects was 5 days. Children of the control group received standard treatment for acute respiratory viral infections without Laferobionum®. Objective research included: auscultation of the heart and lungs, examination of the skin and mucous membranes, measurement of heart rate, blood pressure and body temperature. All patients underwent a general blood test, a general urinalysis, identification of the pathogen using the method of direct immunofluorescence (in smears taken from the nasal passages in the laboratory “Medical Diagnostic Center of Dnipropetrovsk Medical Academy”. Results. In the non-epidemic period, the respiratory syncytial virus and adenoviruses were the leading viral pathogens of acute respiratory viral infections. The main clinical manifestations of acute respiratory viral infection in the observed patients were signs of general inflammatory and catarrhal syndromes. All patients had not severe course of the disease. The data of the physical examination performed before the beginning of treatment indicated the absence of clinically significant deviations from the cardiovascular system in the children of the main and control groups. Arterial blood pressure and heart rate in the subjects of both groups were

  17. The relationship between history and physical examination findings and the outcome of electrodiagnostic testing in patients with sciatica referred to physical therapy.

    Science.gov (United States)

    Savage, Nathan J; Fritz, Julie M; Thackeray, Anne

    2014-07-01

    Cross-sectional diagnostic accuracy study. To investigate the relationship between history and physical examination findings and the outcome of electrodiagnostic testing in patients with sciatica referred to physical therapy. Electrodiagnostic testing is routinely used to evaluate patients with sciatica. Recent evidence suggests that the presence of radiculopathy identified with electrodiagnostic testing may predict better functional outcomes in these patients. While some patient history and physical examination findings have been shown to predict the presence of disc herniation or neurological insult, little is known about their relationship to the results of electrodiagnostic testing. Electrodiagnostic testing was performed on 38 patients with sciatica who participated in a randomized trial that compared different physical therapy interventions. The diagnostic gold standard was the presence or absence of radiculopathy, based on the results of the needle electromyographic examination. Diagnostic sensitivity and specificity values were calculated, along with corresponding likelihood ratios, for select patient history and physical examination variables. No significant relationship was found between select patient history and physical examination findings, analyzed individually or in combination, and the outcome of electrodiagnostic testing. Diagnostic sensitivity values ranged from 0.03 (95% confidence interval [CI]: 0.00, 0.24) to a high of 0.95 (95% CI: 0.72, 0.99), and specificity values ranged from 0.10 (95% CI: 0.02, 0.34) to a high of 0.95 (95% CI: 0.72, 0.99). Positive likelihood ratios ranged from 0.15 (95% CI: 0.01, 2.87) to a high of 2.33 (95% CI: 0.71, 7.70), and negative likelihood ratios ranged from 2.00 (95% CI: 0.35, 11.48) to a low of 0.50 (95% CI: 0.03, 8.10). In this investigation, the relationship between patient history and physical examination findings and the outcome of electrodiagnostic testing among patients with sciatica was not found to be

  18. Examining the relationship between psychosocial working conditions, physical work demands, and leisure time physical activity in Canada.

    Science.gov (United States)

    Morassaei, Sara; Smith, Peter M

    2011-10-01

    To examine the effects of psychosocial working conditions and physical work demands on leisure time physical activity (LTPA). Using path analysis, direct and indirect effects of self-reported working conditions on LTPA levels were assessed in a representative sample of 4167 workers from the 2000 to 2001 Canadian National Population Health Survey. Higher levels of skill discretion and decision latitude were associated with higher LTPA. Physical work demands had opposite effects among men versus women, and skill discretion had a stronger effect among women than among men. Job security had a stronger effect on older workers and those without children younger than 13 years. The results support the influence of the work environment on LTPA and suggest that certain work conditions should be targeted in future interventions seeking to impact participation in physical activity.

  19. Accuracy of Medical Students in Detecting Pleural Effusion Using Lung Ultrasound as an Adjunct to the Physical Examination.

    Science.gov (United States)

    Steinmetz, Peter; Oleskevich, Sharon; Dyachenko, Alina; McCusker, Jane; Lewis, John

    2018-03-25

    This study compared the accuracy of medical students in identifying pleural effusion in hospitalized patients using the physical examination versus lung ultrasound (US). Fourth-year medical students (n = 14) received 20 hours of general practical US training (including 2 hours of specialized lung US training) plus theoretical and video documentation. The students used the physical examination alone versus the physical examination plus lung US to document the presence or absence of pleural effusion in the right and left hemithoraces of hospitalized patients (n = 11 patients; 22 hemithoraces examined 544 times in total). The reference standard for identification of pleural effusion was a lung US examination by 2 expert point-of-care sonographers. The odds of correctly identifying the presence versus absence of pleural effusion was 5 times greater with lung US as an adjunct to the physical examination compared to the physical examination alone (odds ratio [OR], 5.1 from multivariate logistic regression; 95% confidence interval, 3.3-8.0). The addition of lung US to the physical examination resulted in an increase in sensitivity from 48% to 90%, in specificity from 73% to 86%, and in accuracy from 60% to 88%. The benefits of using US were greater when pleural effusion was present versus absent (OR, 10.8 versus 2.4) and when examining older versus younger patients (OR, 10.2 versus 2.8). These results demonstrate that medical students' ability to detect the presence or absence of pleural effusion is superior when using lung US as an adjunct to the physical examination than when using the physical examination alone. © 2018 by the American Institute of Ultrasound in Medicine.

  20. Influence of the workplace on learning physical examination skills

    Science.gov (United States)

    2014-01-01

    Background Hospital clerkships are considered crucial for acquiring competencies such as diagnostic reasoning and clinical skills. The actual learning process in the hospital remains poorly understood. This study investigates how students learn clinical skills in workplaces and factors affecting this. Methods Six focus group sessions with 32 students in Internal Medicine rotation (4–9 students per group; sessions 80–90 minutes). Verbatim transcripts were analysed by emerging themes and coded independently by three researchers followed by constant comparison and axial coding. Results Students report to learn the systematics of the physical examination, gain agility and become able to recognise pathological signs. The learning process combines working alongside others and working independently with increasing responsibility for patient care. Helpful behaviour includes making findings explicit through patient files or during observation, feedback by abnormal findings and taking initiative. Factors affecting the process negatively include lack of supervision, uncertainty about tasks and expectations, and social context such as hierarchy of learners and perceived learning environment. Conclusion Although individual student experiences vary greatly between different hospitals, it seems that proactivity and participation are central drivers for learning. These results can improve the quality of existing programmes and help design new ways to learn physical examination skills. PMID:24678562

  1. Femoral anteversion assessment: Comparison of physical examination, gait analysis, and EOS biplanar radiography.

    Science.gov (United States)

    Westberry, David E; Wack, Linda I; Davis, Roy B; Hardin, James W

    2018-05-01

    Multiple measurement methods are available to assess transverse plane alignment of the lower extremity. This study was performed to determine the extent of correlation between femoral anteversion assessment using simultaneous biplanar radiographs and three-dimensional modeling (EOS imaging), clinical hip rotation by physical examination, and dynamic hip rotation assessed by gait analysis. Seventy-seven patients with cerebral palsy (GMFCS Level I and II) and 33 neurologically typical children with torsional abnormalities completed a comprehensive gait analysis with same day biplanar anterior-posterior and lateral radiographs and three-dimensional transverse plane assessment of femoral anteversion. Correlations were determined between physical exam of hip rotation, EOS imaging of femoral anteversion, and transverse plane hip kinematics for this retrospective review study. Linear regression analysis revealed a weak relationship between physical examination measures of hip rotation and biplanar radiographic assessment of femoral anteversion. Similarly, poor correlation was found between clinical evaluation of femoral anteversion and motion assessment of dynamic hip rotation. Correlations were better in neurologically typical children with torsional abnormalities compared to children with gait dysfunction secondary to cerebral palsy. Dynamic hip rotation cannot be predicted by physical examination measures of hip range of motion or from three-dimensional assessment of femoral anteversion derived from biplanar radiographs. Copyright © 2018 Elsevier B.V. All rights reserved.

  2. Respiratory

    Science.gov (United States)

    The words "respiratory" and "respiration" refer to the lungs and breathing. ... Boron WF. Organization of the respiratory system. In: Boron WF, Boulpaep EL, eds. Medical Physiology . 3rd ed. Philadelphia, PA: Elsevier; 2017:chap 26.

  3. Self-Reported Mental Health Predicts Acute Respiratory Infection.

    Science.gov (United States)

    Maxwell, Lizzie; Barrett, Bruce; Chase, Joseph; Brown, Roger; Ewers, Tola

    2015-06-01

    Poor mental health conditions, including stress and depression, have been recognized as a risk factor for the development of acute respiratory infection. Very few studies have considered the role of general mental health in acute respiratory infection occurrence. The aim of this analysis is to determine if overall mental health, as assessed by the mental component of the Short Form 12 Health Survey, predicts incidence, duration, or severity of acute respiratory infection. Data utilized for this analysis came from the National Institute of Health-funded Meditation or Exercise for Preventing Acute Respiratory Infection (MEPARI) and MEPARI-2 randomized controlled trials examining the effects of meditation or exercise on acute respiratory infection among adults aged > 30 years in Madison, Wisconsin. A Kendall tau rank correlation compared the Short Form 12 mental component, completed by participants at baseline, with acute respiratory infection incidence, duration, and area-under-the-curve (global) severity, as assessed by the Wisconsin Upper Respiratory Symptom Survey. Participants were recruited from Madison, Wis, using advertisements in local media. Short Form 12 mental health scores significantly predicted incidence (P = 0.037) of acute respiratory infection, but not duration (P = 0.077) or severity (P = 0.073). The Positive and Negative Affect Schedule (PANAS) negative emotion measure significantly predicted global severity (P = 0.036), but not incidence (P = 0.081) or duration (P = 0.125). Mindful Attention Awareness Scale scores significantly predicted incidence of acute respiratory infection (P = 0.040), but not duration (P = 0.053) or severity (P = 0.70). The PHQ-9, PSS-10, and PANAS positive measures did not show significant predictive associations with any of the acute respiratory infection outcomes. Self-reported overall mental health, as measured by the mental component of Short Form 12, predicts acute respiratory infection incidence.

  4. The respiratory microbiome and respiratory infections

    NARCIS (Netherlands)

    Unger, Stefan A.; Bogaert, Debby

    2017-01-01

    Despite advances over the past ten years lower respiratory tract infections still comprise around a fifth of all deaths worldwide in children under five years of age with the majority in low- and middle-income countries. Known risk factors for severe respiratory infections and poor chronic

  5. Computational Fluid and Particle Dynamics in the Human Respiratory System

    CERN Document Server

    Tu, Jiyuan; Ahmadi, Goodarz

    2013-01-01

    Traditional research methodologies in the human respiratory system have always been challenging due to their invasive nature. Recent advances in medical imaging and computational fluid dynamics (CFD) have accelerated this research. This book compiles and details recent advances in the modelling of the respiratory system for researchers, engineers, scientists, and health practitioners. It breaks down the complexities of this field and provides both students and scientists with an introduction and starting point to the physiology of the respiratory system, fluid dynamics and advanced CFD modeling tools. In addition to a brief introduction to the physics of the respiratory system and an overview of computational methods, the book contains best-practice guidelines for establishing high-quality computational models and simulations. Inspiration for new simulations can be gained through innovative case studies as well as hands-on practice using pre-made computational code. Last but not least, students and researcher...

  6. Effects of Combined Training with Breathing Resistance and Sustained Physical Exertion to Improve Endurance Capacity and Respiratory Muscle Function in Healthy Young Adults

    OpenAIRE

    Kido, Satoshi; Nakajima, Yasuhiro; Miyasaka, Tomoya; Maeda, Yusuke; Tanaka, Toshiaki; Yu, Wenwei; Maruoka, Hiroshi; Takayanagi, Kiyomi

    2013-01-01

    [Purpose] In this study, combined training with breathing resistance and sustained physical exertion was carried out to evaluate its physiological effects and its effect on improve endurance capacity. [Subjects and Methods] The subjects were nine healthy adults (mean age 20.4, SD ? 1.7?years). The combined training group (n = 5) carried out 6 weeks of combined training using a cycle ergometer, with exercise load tests and respiratory function tests performed before and after the training. The...

  7. Is recurrent respiratory infection associated with allergic respiratory disease?

    Science.gov (United States)

    de Oliveira, Tiago Bittencourt; Klering, Everton Andrei; da Veiga, Ana Beatriz Gorini

    2018-03-13

    Respiratory infections cause high morbidity and mortality worldwide. This study aims to estimate the relationship between allergic respiratory diseases with the occurrence of recurrent respiratory infection (RRI) in children and adolescents. The International Study of Asthma and Allergies in Childhood questionnaire and a questionnaire that provides data on the history of respiratory infections and the use of antibiotics were used to obtain data from patients. The relationship between the presence of asthma or allergic rhinitis and the occurrence of respiratory infections in childhood was analyzed. We interviewed the caregivers of 531 children aged 0 to 15 years. The average age of participants was 7.43 years, with females accounting for 52.2%. This study found significant relationship between: presence of asthma or allergic rhinitis with RRI, with prevalence ratio (PR) of 2.47 (1.51-4.02) and 1.61 (1.34-1.93), respectively; respiratory allergies with use of antibiotics for respiratory problems, with PR of 5.32 (2.17-13.0) for asthma and of 1.64 (1.29-2.09) for allergic rhinitis; asthma and allergic rhinitis with diseases of the lower respiratory airways, with PR of 7.82 (4.63-13.21) and 1.65 (1.38-1.96), respectively. In contrast, no relationship between upper respiratory airway diseases and asthma and allergic rhinitis was observed, with PR of 0.71 (0.35-1.48) and 1.30 (0.87-1.95), respectively. RRI is associated with previous atopic diseases, and these conditions should be considered when treating children.

  8. Physical examination tests for the diagnosis of femoroacetabular impingement. A systematic review.

    Science.gov (United States)

    Pacheco-Carrillo, Aitana; Medina-Porqueres, Ivan

    2016-09-01

    Numerous clinical tests have been proposed to diagnose FAI, but little is known about their diagnostic accuracy. To summarize and evaluate research on the accuracy of physical examination tests for diagnosis of FAI. A search of the PubMed, SPORTDiscus and CINAHL databases was performed. Studies were considered eligible if they compared the results of physical examination tests to those of a reference standard. Methodological quality and internal validity assessment was performed by two independent reviewers using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool. The systematic search strategy revealed 298 potential articles, five of which articles met the inclusion criteria. After assessment using the QUADAS score, four of the five articles were of high quality. Clinical tests included were Impingement sign, IROP test (Internal Rotation Over Pressure), FABER test (Flexion-Abduction-External Rotation), Stinchfield/RSRL (Resisted Straight Leg Raise) test, Scour test, Maximal squat test, and the Anterior Impingement test. IROP test, impingement sign, and FABER test showed the most sensitive values to identify FAI. The diagnostic accuracy of physical examination tests to assess FAI is limited due to its heterogenecity. There is a strong need for sound research of high methodological quality in this area. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. Physical examination-indicated cerclage in singleton and twin pregnancies: maternal-fetal outcomes.

    Science.gov (United States)

    Bernabeu, Andrea; Goya, Maria; Martra, Miquel; Suy, Anna; Pratcorona, Laia; Merced, Carme; Llurba, Elisa; Casellas, Manel; Carreras, Elena; Cabero, Luis

    2016-01-01

    To study maternal and perinatal outcomes after physical examination-indicated cerclage in both singleton and twin pregnancies and evaluate the possible risk factors associated. Retrospective review of all women undergoing physical examination-indicated cerclage at the Hospital Vall d'Hebro, Barcelona from January 2009 to December 2012 after being diagnosed with cervical incompetence and risk of premature birth. During the study period, 60 cases of women diagnosed with cervical incompetence who were carrying live and morphologically-normal fetuses (53 singleton and 7 twin pregnancies), and who had an imminent risk of premature birth were evaluated. Mean gestational age until birth was 35 weeks in singleton and 32 weeks in twin pregnancies. Four cases (7.5%) of immature births and one case (2.0%) of neonatal death were recorded in singleton pregnancies. No cases of immature births or neonatal deaths were recorded in twin pregnancies. Diagnostic amniocentesis was performed IN all cases to rule out possible chorioamnionitis. Physical examination-indicated cerclage for cervical incompetence in women at risk for immature or preterm birth demonstrates good perinatal prognosis without increasing maternal morbidity in either singleton or twin pregnancies. The increase in gestation time in our study may also have been due to the fact that patients with subclinical chorioamnionitis were excluded by diagnostic amniocentesis.

  10. The scientific basis for postoperative respiratory care.

    Science.gov (United States)

    Branson, Richard D

    2013-11-01

    Postoperative pulmonary complications (PPCs) are common and expensive. Costs, morbidity, and mortality are higher with PPCs than with cardiac or thromboembolic complications. Preventing and treating PPCs is a major focus of respiratory therapists, using a wide variety of techniques and devices, including incentive spirometry, CPAP, positive expiratory pressure, intrapulmonary percussive ventilation, and chest physical therapy. The scientific evidence for these techniques is lacking. CPAP has some evidence of benefit in high risk patients with hypoxemia. Incentive spirometry is used frequently, but the evidence suggests that incentive spirometry alone has no impact on PPC. Chest physical therapy, which includes mechanical clapping and postural drainage, appears to worsen atelectasis secondary to pain and splinting. As with many past respiratory therapy techniques, the profession needs to take a hard look at these techniques and work to provide only practices based on good evidence. The idea of a PPC bundle has merit and should be studied in larger, multicenter trials. Additionally, intraoperative ventilation may play a key role in the development of PPCs and should receive greater attention.

  11. Point-of-care cardiac ultrasound techniques in the physical examination: better at the bedside.

    Science.gov (United States)

    Kimura, Bruce J

    2017-07-01

    The development of hand-carried, battery-powered ultrasound devices has created a new practice in ultrasound diagnostic imaging, called 'point-of-care' ultrasound (POCUS). Capitalising on device portability, POCUS is marked by brief and limited ultrasound imaging performed by the physician at the bedside to increase diagnostic accuracy and expediency. The natural evolution of POCUS techniques in general medicine, particularly with pocket-sized devices, may be in the development of a basic ultrasound examination similar to the use of the binaural stethoscope. This paper will specifically review how POCUS improves the limited sensitivity of the current practice of traditional cardiac physical examination by both cardiologists and non-cardiologists. Signs of left ventricular systolic dysfunction, left atrial enlargement, lung congestion and elevated central venous pressures are often missed by physical techniques but can be easily detected by POCUS and have prognostic and treatment implications. Creating a general set of repetitive imaging skills for these entities for application on all patients during routine examination will standardise and reduce heterogeneity in cardiac bedside ultrasound applications, simplify teaching curricula, enhance learning and recollection, and unify competency thresholds and practice. The addition of POCUS to standard physical examination techniques in cardiovascular medicine will result in an ultrasound-augmented cardiac physical examination that reaffirms the value of bedside diagnosis. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  12. Diagnosis of Pediatric Foreign Body Ingestion: Clinical Presentation, Physical Examination, and Radiologic Findings.

    Science.gov (United States)

    Sink, Jacquelyn R; Kitsko, Dennis J; Mehta, Deepak K; Georg, Matthew W; Simons, Jeffrey P

    2016-04-01

    (1) To describe clinical and radiologic findings in patients with esophageal foreign bodies. (2) To examine the sensitivity and specificity of history, physical examination, and radiologic studies in children with suspected foreign body ingestion. A retrospective cohort study was performed evaluating all children who underwent esophagoscopy for suspected foreign body ingestion at our institution from 2006 to 2013. Five hundred forty-three patients were included (54% male). Average age was 4.7 years (SD = 4.1 years). Foreign bodies were identified on esophagoscopy in 497 cases (92%). Ingestion was witnessed in 23% of cases. Most common presenting symptoms were choking/gagging (49%), vomiting (47%), and dysphagia/odynophagia (42%). Most patients with foreign bodies had a normal exam (76%). Most foreign bodies were radiopaque (83%). In 59% of patients with normal chest radiographs, a foreign body was present. Sensitivity and specificity of 1 or more findings on history, physical examination, and imaging were 99% and 0%, 21% and 76%, and 83% and 100%, respectively. Most patients with esophageal foreign bodies are symptomatic. Although many patients will have a normal physical examination, an abnormal exam should increase suspicion for a foreign body. Most esophageal foreign bodies are radiopaque, but a normal chest radiograph cannot rule out a foreign body. © The Author(s) 2015.

  13. Climate change and respiratory disease: European Respiratory Society position statement.

    Science.gov (United States)

    Ayres, J G; Forsberg, B; Annesi-Maesano, I; Dey, R; Ebi, K L; Helms, P J; Medina-Ramón, M; Windt, M; Forastiere, F

    2009-08-01

    Climate change will affect individuals with pre-existing respiratory disease, but the extent of the effect remains unclear. The present position statement was developed on behalf of the European Respiratory Society in order to identify areas of concern arising from climate change for individuals with respiratory disease, healthcare workers in the respiratory sector and policy makers. The statement was developed following a 2-day workshop held in Leuven (Belgium) in March 2008. Key areas of concern for the respiratory community arising from climate change are discussed and recommendations made to address gaps in knowledge. The most important recommendation was the development of more accurate predictive models for predicting the impact of climate change on respiratory health. Respiratory healthcare workers also have an advocatory role in persuading governments and the European Union to maintain awareness and appropriate actions with respect to climate change, and these areas are also discussed in the position statement.

  14. Two cases of rickets presenting with poor growth, hypotonia, and respiratory problems.

    Science.gov (United States)

    Wouters, E; Wojciechowski, M; de Vries, E

    2015-06-01

    Rickets is a rare disease in developed countries. In children, it is a disease which affects growing bone. Depending on the severity, it can present with a wide variety of symptoms. Because it is such a rare disease in developed countries, symptoms suggesting rickets are often not easily recognized. This can cause a delay in diagnosing and treating rickets. Often unnecessary and sometimes invasive investigations are performed. First leading clues to rickets on physical examination are poor growth, especially length, thickening of wrists, bow legs, and craniotabes. At further examination, special attention should be paid to osteopenia and cupping and fraying at the metaphyses on X-rays. Laboratory results suggestive for rickets are elevated alkaline phosphatase and disturbances in calcium and phosphate homeostasis. In this report, we present two cases presenting with poor growth, severe pain, and respiratory problems secondary to calcipenic rickets.

  15. Hip Dysplasia: Clinical Signs and Physical Examination Findings.

    Science.gov (United States)

    Syrcle, Jason

    2017-07-01

    Hip dysplasia is a common developmental disorder of the dog, consisting of varying degrees of hip laxity, progressive remodeling of the structures of the hip, and subsequent development of osteoarthritis. It is a juvenile-onset condition, with clinical signs often first evident at 4 to 12 months of age. A tentative diagnosis of hip dysplasia can be made based on signalment, history, and physical examination findings. The Ortolani test is a valuable tool for identifying juvenile dogs affected with this condition. Further diagnostics can then be prioritized, contributing to prompt diagnosis and appropriate treatment. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Physical examination tests for hip dysfunction and injury.

    Science.gov (United States)

    Reiman, Michael P; Mather, Richard C; Cook, Chad E

    2015-03-01

    Physical examination tests for hip dysfunction and injury of the strongest diagnostic accuracy were identified in a recent systematic review with meta-analysis in BJSM. These tests are described in this article. A detailed description of the various different tests is given, with photographs for each test procedure. Diagnostic interpretation of each test requires careful consideration, with special attention to specific variables such as test performance and patient population. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  17. Prevalence of Human Papillomavirus (HPV in upper respiratory tract mucosa in a group of pre-school children

    Directory of Open Access Journals (Sweden)

    Jaroslaw Szydłowski

    2014-11-01

    Full Text Available [b]introduction[/b]. Human Papillomavirus (HPV is a group of DNA viruses which is an etiological factor of many benign and malignant diseases of the upper respiratory tract mucosa, female genital tract and the skin. HPV infection is considered a sexually-transmitted infection, but can also be transmitted by non-sexual routes, including perinatal vertical transmission, physical contact, iatrogenic infection and autoinoculation. Recurrent Respiratory Papillomatosis (RRP in children is connected with HPV infection transmitted vertically from mother to child during the passage of the foetus through an infected birth canal. [b]objective. [/b]The aim of this study was to establish the level of Human Papillomaviruses carrier state in upper respiratory tract mucosa in healthy pre-school children, and to identify potential risk factors for HPV infection. [b]materials and method[/b]. After obtaining consent from their parents, 97 pre-school children were examined – 51 girls and 46 boys between the ages of 3 – 5 years; average age – 4 years and 5 months. 68 children were urban dwellers and 29 came from a rural environment. A questionnaire with detailed history was taken including parents’ and child`s personal data, as well as perinatal risk factors in pregnancy. Socio-demographic information was also obtained, including the standard of living, and chosen environmental factors. Routine ENT examination was performed. Exfoliated oral squamous cells were collected from swabs and analysed for the presence of DNA papillomaviruses by polymerase chain reaction. [b]results.[/b] The presence of HPV in the respiratory tract in children was detected in 19.6% cases. ‘High oncogenic potential’ HPVs, such as HPV-16 and HPV-18, were not observed in squamous cell mucosa of the respiratory tract in the children. No significant differences were observed between the HPV carrier state in urban and rural inhabitants.

  18. Effect of training and rest on respiratory mechanical properties in racing sled dogs.

    Science.gov (United States)

    Davis, Michael; Williamson, Katherine; McKenzie, Erica; Royer, Christopher; Payton, Mark; Nelson, Stuart

    2005-02-01

    Racing Alaskan sled dogs develop exercise-induced airway inflammation, similar to that reported for elite human athletes participating in cold-weather sports. These human athletes also have airway hyperresponsiveness, but airway function in sled dogs has not been measured. To compare respiratory mechanical properties in trained, rested Alaskan sled dogs with typical laboratory hounds, and to determine whether subsequent training alters respiratory mechanical properties. Nineteen healthy adult Alaskan sled dogs were compared with five healthy adult mixed-breed laboratory hounds. All dogs were rested for at least 4 months before examination. Respiratory mechanical properties were measured while the dogs were anesthetized and ventilated with a piston ventilator. The mean respiratory resistance and compliance measurements for 20 consecutive breaths were used as baseline values immediately before measurement of respiratory reactivity. Respiratory reactivity was the mean of 20 consecutive breaths immediately after the administration of aerosol histamine, expressed as the percentage change in prehistamine measurements. After the initial examinations, the sled dogs were divided into exercised and controls. Exercised dogs were trained for competitive endurance racing. Both groups were examined after 2 and 4 months of training. Alaskan sled dogs had greater respiratory compliance reactivity to histamine (77.47 +/- 8.58% baseline) compared with laboratory dogs (87.60 +/- 9.22% baseline). There was no effect of training on respiratory mechanical properties detected in racing sled dogs. Racing Alaskan sled dogs have airway dysfunction similar to "ski asthma" that persists despite having 4 months of rest. These findings suggest that repeated exercise in cold conditions can lead to airway disease that does not readily resolve with cessation of exercise.

  19. RCT: Module 2.07, Respiratory Protection, Course 8773

    Energy Technology Data Exchange (ETDEWEB)

    Hillmer, Kurt T. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2017-08-10

    Internal dosimetry controls require the use of engineering controls to prevent the internal deposition of radioactive and nonradiological contaminants. However, when engineering and administrative controls are not available or feasible, respiratory protection may be necessary. The radiation control technician (RCT) should know and apply the considerations used in determining the respiratory protection equipment that is most appropriate for the job. The inappropriate use of or the use of the wrong respiratory protection equipment may result in undesirable health effects. This course will prepare the student with the skills necessary for RCT qualification by passing quizzes, tests, and the RCT Comprehensive Phase 1, Unit 2 Examination (TEST 27566) and will provide in-the-field skills.

  20. Measurements of respiratory illness among construction painters.

    Science.gov (United States)

    White, M C; Baker, E L

    1988-08-01

    The prevalence of different measurements of respiratory illness among construction painters was examined and the relation between respiratory illness and employment as a painter assessed in a cross sectional study of current male members of two local affiliates of a large international union of painters. Respiratory illness was measured by questionnaire and spirometry. Longer employment as a painter was associated with increased prevalence of chronic obstructive disease and an interactive effect was observed for smoking and duration of employment as a painter. Multiple regression analysis showed a significant association between years worked as a painter and a decrement in FEV1 equal to about 11 ml for each year worked. This association was larger among painters who had smoked. The prevalence of chronic bronchitis was significantly associated with increased use of spray application methods.

  1. The Examination of the Attitudes of Secondary School Students towards Physical Education Course

    Science.gov (United States)

    Keskin, Özkan; Hergüner, Gülten; Dönmez, Ahmet; Berisha, Milaim; Üçan, Erkan

    2017-01-01

    The aim of this study is to examine the attitudes of primary education students towards physical education courses according to certain variables. 640 students from elementary schools in the city center and several counties of Sakarya participated in the study. In the designating of the students' attitudes towards the physical education courses,…

  2. Partnering for optimal respiratory home care: physicians working with respiratory therapists to optimally meet respiratory home care needs.

    Science.gov (United States)

    Spratt, G; Petty, T L

    2001-05-01

    The need for respiratory care services continues to increase, reimbursement for those services has decreased, and cost-containment measures have increased the frequency of home health care. Respiratory therapists are well qualified to provide home respiratory care, reduce misallocation of respiratory services, assess patient respiratory status, identify problems and needs, evaluate the effect of the home setting, educate the patient on proper equipment use, monitor patient response to and complications of therapy, monitor equipment functioning, monitor for appropriate infection control procedures, make recommendations for changes to therapy regimen, and adjust therapy under the direction of the physician. Teamwork benefits all parties and offers cost and time savings, improved data collection and communication, higher job satisfaction, and better patient monitoring, education, and quality of life. Respiratory therapists are positioned to optimize treatment efficacy, maximize patient compliance, and minimize hospitalizations among patients receiving respiratory home care.

  3. Alcohol, smoking, and physical activity related to respiratory infections in elderly people

    NARCIS (Netherlands)

    Horst-Graat, van der J.M.; Terpstra, J.S.; Kok, F.J.; Schouten, E.G.

    2007-01-01

    OBJECTIVE: Elderly people show an increased risk of acute respiratory infections and their complications. This increased susceptibility may be the result of immunosenescence. If lifestyle factors could influence the risk of the infections, this could result in great public health relevance. We

  4. Instantaneous Respiratory Estimation from Thoracic Impedance by Empirical Mode Decomposition.

    Science.gov (United States)

    Wang, Fu-Tai; Chan, Hsiao-Lung; Wang, Chun-Li; Jian, Hung-Ming; Lin, Sheng-Hsiung

    2015-07-07

    Impedance plethysmography provides a way to measure respiratory activity by sensing the change of thoracic impedance caused by inspiration and expiration. This measurement imposes little pressure on the body and uses the human body as the sensor, thereby reducing the need for adjustments as body position changes and making it suitable for long-term or ambulatory monitoring. The empirical mode decomposition (EMD) can decompose a signal into several intrinsic mode functions (IMFs) that disclose nonstationary components as well as stationary components and, similarly, capture respiratory episodes from thoracic impedance. However, upper-body movements usually produce motion artifacts that are not easily removed by digital filtering. Moreover, large motion artifacts disable the EMD to decompose respiratory components. In this paper, motion artifacts are detected and replaced by the data mirrored from the prior and the posterior before EMD processing. A novel intrinsic respiratory reconstruction index that considers both global and local properties of IMFs is proposed to define respiration-related IMFs for respiration reconstruction and instantaneous respiratory estimation. Based on the experiments performing a series of static and dynamic physical activates, our results showed the proposed method had higher cross correlations between respiratory frequencies estimated from thoracic impedance and those from oronasal airflow based on small window size compared to the Fourier transform-based method.

  5. Analyzing non-respiratory movements of the chest: methods and devices

    Science.gov (United States)

    Pariaszewska, Katarzyna; Młyńczak, Marcel; Cybulski, Gerard

    2015-09-01

    Respiration is the main reason of the chest movements. However, there are also non-respiratory ones, resulting from e.g. snoring, wheezing, stridor, throat clearing or coughing. They may exist sporadically, however should be examined in case when their incidences increase. Detecting non-respiratory movements is very important, because many of them are symptoms of respiratory diseases such as asthma, chronic obstructive pulmonary disease (COPD) or lung cancer. Assessment of the presence of non-respiratory movements could be important element of effective diagnosis. It is also necessary to provide quantitative and objective results for intra-subject studies. Most of these events generate vibroacoustic signals that contain components of sound and vibrations. This work provides the review of the solutions and devices for monitoring of the non-respiratory movements, primarily considering the accuracy of the chest movements' detection and distinguishing.

  6. [Epidemiology of secretory otitis media in children examined at the Otolaryngologic Clinic in Wrocław in 1996-1999].

    Science.gov (United States)

    Pośpiech, Lucyna; Rak, Jerzy; Jaworska, Marzena; Klempous, Joanna

    2002-01-01

    The aim of the work was an evaluation of epidemiological factors in otitis media with effusion (OME) in children. Material consisted of 191 children treated surgically in Wroclaw ENT Clinic. The control group consisted of 95 healthy children. The evaluation was based on detailed history of the patients and physical ORL examination. The factors taken into considerations were: age, sex, birth factors, breast feeding, attending to kindergarten, passive smoking, social and environmental factors, incidents of upper respiratory airways and middle ear infections before OME being diagnosed. Frequent upper respiratory infections, acute and recurrent middle ear infections, staying with other children (kindergarten) and passive smoking increase the risk of OME incidence.

  7. Respiratory system model for quasistatic pulmonary pressure-volume (P-V) curve: inflation-deflation loop analyses.

    Science.gov (United States)

    Amini, R; Narusawa, U

    2008-06-01

    A respiratory system model (RSM) is developed for the deflation process of a quasistatic pressure-volume (P-V) curve, following the model for the inflation process reported earlier. In the RSM of both the inflation and the deflation limb, a respiratory system consists of a large population of basic alveolar elements, each consisting of a piston-spring-cylinder subsystem. A normal distribution of the basic elements is derived from Boltzmann statistical model with the alveolar closing (opening) pressure as the distribution parameter for the deflation (inflation) process. An error minimization by the method of least squares applied to existing P-V loop data from two different data sources confirms that a simultaneous inflation-deflation analysis is required for an accurate determination of RSM parameters. Commonly used terms such as lower inflection point, upper inflection point, and compliance are examined based on the P-V equations, on the distribution function, as well as on the geometric and physical properties of the basic alveolar element.

  8. Novel Use of Ultrasound to Teach Reproductive System Physical Examination Skills and Pelvic Anatomy.

    Science.gov (United States)

    Parikh, Tejal; Czuzak, Maria; Bui, Naomi; Wildner, Corinna; Koch, Bryna; Leko, Elizabeth; Rappaport, William; Adhikari, Srikar; Gordon, Paul; Gura, Mike; Ellis, Susan

    2018-03-01

    To determine whether integration of ultrasound (US) into a reproductive system examination clinical skills lab can increase confidence in palpating key reproductive structures during testicular and bimanual pelvic examinations, reduce anxiety about conducting testicular and bimanual pelvic examinations, and improve performance on multiple-choice questions based on structure identification using US images. Second-year medical students enrolled in the Life Cycle preclinical course participated in this cross-sectional study. A single learning activity was developed to pair the teaching of the reproductive system physical examination with the use of US in the clinical skills lab. The evaluation of the teaching session consisted of a pre-post analysis of student self-reported knowledge, confidence, and anxiety. The response rate for the pre survey was 82% (n = 96), and the rate for the post survey was 79% (n = 93). Students' confidence in their ability to identify reproductive system structures on US images increased from pre to post survey. Their confidence in their ability to palpate the epididymis, uterus, and ovary during a physical examination improved, and their anxiety about conducting testicular and bimanual pelvic examinations decreased. Student satisfaction with the session was high. Students' performance on multiple-choice questions based on structure identification using US images was at 96% or higher. Our study findings support the integration of US into a reproductive system examination clinical skills lab. Medical students acquire competency and confidence in reproductive system physical examination skills with US integration. © 2017 by the American Institute of Ultrasound in Medicine.

  9. Pre-Participation Physical Examinations

    Science.gov (United States)

    ... live longer, healthier lives. Research shows that moderate physical activity – such as 30 minutes a day of brisk walking – significantly contributes to longevity. Even a person with risk factors like high ...

  10. Gas cooking, respiratory and allergic outcomes in the PIAMA birth cohort study

    NARCIS (Netherlands)

    Lin, Weiwei; Gehring, Ulrike; Oldenwening, Marieke; de Jongste, Johan C.; Kerkhof, Marjan; Postma, Dirkje; Smit, Henriette A.; Wijga, Alet H.; Brunekreef, Bert

    Objectives Evidence for a relationship between gas cooking and childhood respiratory health is inconsistent and few longitudinal studies have been reported. Our aim was to examine the association between gas cooking and the development of respiratory and allergic outcomes longitudinally in a

  11. A Mokken scale analysis of the peer physical examination questionnaire.

    Science.gov (United States)

    Vaughan, Brett; Grace, Sandra

    2018-01-01

    Peer physical examination (PPE) is a teaching and learning strategy utilised in most health profession education programs. Perceptions of participating in PPE have been described in the literature, focusing on areas of the body students are willing, or unwilling, to examine. A small number of questionnaires exist to evaluate these perceptions, however none have described the measurement properties that may allow them to be used longitudinally. The present study undertook a Mokken scale analysis of the Peer Physical Examination Questionnaire (PPEQ) to evaluate its dimensionality and structure when used with Australian osteopathy students. Students enrolled in Year 1 of the osteopathy programs at Victoria University (Melbourne, Australia) and Southern Cross University (Lismore, Australia) were invited to complete the PPEQ prior to their first practical skills examination class. R, an open-source statistics program, was used to generate the descriptive statistics and perform a Mokken scale analysis. Mokken scale analysis is a non-parametric item response theory approach that is used to cluster items measuring a latent construct. Initial analysis suggested the PPEQ did not form a single scale. Further analysis identified three subscales: 'comfort', 'concern', and 'professionalism and education'. The properties of each subscale suggested they were unidimensional with variable internal structures. The 'comfort' subscale was the strongest of the three identified. All subscales demonstrated acceptable reliability estimation statistics (McDonald's omega > 0.75) supporting the calculation of a sum score for each subscale. The subscales identified are consistent with the literature. The 'comfort' subscale may be useful to longitudinally evaluate student perceptions of PPE. Further research is required to evaluate changes with PPE and the utility of the questionnaire with other health profession education programs.

  12. The respiratory local lymph node assay as a tool to study respiratory sensitizers.

    Science.gov (United States)

    Arts, Josje H E; de Jong, Wim H; van Triel, Jos J; Schijf, Marcel A; de Klerk, Arja; van Loveren, Henk; Kuper, C Frieke

    2008-12-01

    The local lymph node assay (LLNA) is used to test the potential of low molecular weight (LMW) compounds to induce sensitization via the skin. In the present study, a respiratory LLNA was developed. Male BALB/c mice were exposed head/nose-only during three consecutive days for 45, 90, 180, or 360 min/day to various LMW allergens. Ear application (skin LLNA) was used as a positive control. Negative controls were exposed to the vehicle. Three days after the last exposure, proliferation was determined in the draining mandibular lymph nodes, and the respiratory tract was examined microscopically. Upon inhalation, the allergens trimellitic anhydride, phthalic anhydride, hexamethylene diisocyanate, toluene diisocyanate, isophorone diisocyanate (IPDI), dinitrochlorobenzene, and oxazolone were positive and showed stimulation indices (SIs) up to 11, whereas trimeric IPDI, formaldehyde, and methyl salicylate were negative (viz. SI LLNA.

  13. Clinical Assessment of Physical Examination Maneuvers for Superior Labral Anterior to Posterior Lesions.

    Science.gov (United States)

    Somerville, Lyndsay E; Willits, Kevin; Johnson, Andrew M; Litchfield, Robert; LeBel, Marie-Eve; Moro, Jaydeep; Bryant, Dianne

    2017-10-01

    Purpose  Shoulder pain and disability pose a diagnostic challenge owing to the numerous etiologies and the potential for multiple disorders to exist simultaneously. The evidence to support the use of clinical tests for superior labral anterior to posterior complex (SLAP) is weak or absent. The purpose of this study is to determine the diagnostic validity of physical examination maneuvers for SLAP lesions by performing a methodologically rigorous, clinically applicable study. Methods  We recruited consecutive new shoulder patients reporting pain and/or disability. The physician took a history and indicated their certainty about each possible diagnosis ("certain the diagnosis is absent/present," or "uncertain requires further testing"). The clinician performed the physical tests for diagnoses where uncertainty remained. Magnetic resonance imaging arthrogram and arthroscopic examination were the gold standards. We calculated sensitivity, specificity, and likelihood ratios (LRs) and investigated whether combinations of the top tests provided stronger predictions. Results  Ninety-three patients underwent physical examination for SLAP lesions. When using the presence of a SLAP lesion (Types I-V) as disease positive, none of the tests was sensitive (10.3-33.3) although they were moderately specific (61.3-92.6). When disease positive was defined as repaired SLAP lesion (including biceps tenodesis or tenotomy), the sensitivity (10.5-38.7) and specificity (70.6-93.8) of tests improved although not by a substantial amount. None of the tests was found to be clinically useful for predicting repairable SLAP lesions with all LRs close to one. The compression rotation test had the best LR for both definitions of disease (SLAP tear present = 1.8 and SLAP repaired = 1.67). There was no optimal combination of tests for diagnosing repairable SLAP lesions, with at least two tests positive providing the best combination of measurement properties (sensitivity 46.1% and

  14. Do extra compulsory physical education lessons mean more physically active children--findings from the childhood health, activity, and motor performance school study Denmark (The CHAMPS-study DK).

    Science.gov (United States)

    Møller, Niels Christian; Tarp, Jakob; Kamelarczyk, Eva Friis; Brønd, Jan Christian; Klakk, Heidi; Wedderkopp, Niels

    2014-09-24

    Primarily, this study aims to examine whether children attending sports schools are more active than their counterpart attending normal schools. Secondary, the study aims to examine if physical activity (PA) levels in specific domains differ across school types. Finally, potential modifications by status of overweight/obesity and poor cardio-respiratory fitness are examined. Participants were from the first part of the CHAMPS-study DK, which included approximately 1200 children attending the 0th - 6th grade. At the sports schools, the mandatory physical education (PE) program was increased from 2 to 6 weekly lessons over a 3-year period. Children attending normal schools were offered the standard 2 PE lessons. PA was assessed at two different occasions with the GT3X ActiGraph accelerometer, once during winter in 2009/10 and once during summer/fall in 2010. Leisure time organized sports participation was quantified by SMS track. Based on baseline values in 2008, we generated a high-BMI and a low-cardio-respiratory fitness for age and sex group variable. There were no significant differences in PA levels during total time, PE, or recess between children attending sports schools and normal schools, respectively. However, children, especially boys, attending sports schools were more active during school time than children attending normal schools (girls: β=51, p=0.065; boys: β=113, pactive (girls: β=-41, p=0.004; boys: β=-72, pgirls: β=-0.4, p=0.016; boys: β=-0.2, p=0.236) than children who attended normal schools. Examination of modification by baseline status of overweight/obesity and low cardio-respiratory fitness indicated that during PE low fit girls in particular were more active at sports schools. No differences were revealed in overall PA levels between children attending sports schools and normal schools. Sports schools children were more active than normal schools children during school time, but less active during leisure time. In girls, less organized

  15. Understanding the medical markers of elder abuse and neglect: physical examination findings.

    Science.gov (United States)

    Gibbs, Lisa M

    2014-11-01

    A specific foundation of knowledge is important for evaluating potential abuse from physical findings in the older adult. The standard physical examination is a foundation for detecting many types of abuse. An understanding of traumatic injuries, including patterns of injury, is important for health care providers, and inclusion of elder abuse in the differential diagnosis of patient care is essential. One must possess the skills needed to piece the history, including functional capabilities, and physical findings together. Armed with this skill set, health care providers will develop the confidence needed to identify and intervene in cases of elder abuse. Copyright © 2014 Elsevier Inc. All rights reserved.

  16. Respiratory function in facioscapulohumeral muscular dystrophy 1

    NARCIS (Netherlands)

    Wohlgemuth, M.; Horlings, G.C.; Kooi, E.L. van der; Gilhuis, H.J.; Hendriks, J.C.M.; Maarel, S.M. van der; Engelen, B.G.M. van; Heijdra, Y.F.; Padberg, G.W.A.M.

    2017-01-01

    To test the hypothesis that wheelchair dependency and (kypho-)scoliosis are risk factors for developing respiratory insufficiency in facioscapulohumeral muscular dystrophy, we examined 81 patients with facioscapulohumeral muscular dystrophy 1 of varying degrees of severity ranging from ambulatory

  17. Multiple physical healthcare needs among outpatients with schizophrenia: findings from a health examination study.

    Science.gov (United States)

    Eskelinen, Saana; Sailas, Eila; Joutsenniemi, Kaisla; Holi, Matti; Koskela, Tuomas H; Suvisaari, Jaana

    2017-08-01

    Despite the abundant literature on physical comorbidity, the full range of the concurrent somatic healthcare needs among individuals with schizophrenia has rarely been studied. This observational study aimed to assess the distressing somatic symptoms and needs for physical health interventions in outpatients with schizophrenia, and factors predicting those needs. A structured, comprehensive health examination was carried out, including a visit to a nurse and a general practitioner on 275 outpatients with schizophrenia. The required interventions were classified by type of disease. Logistic regression was used to assess the influence of sociodemographic factors, lifestyle, functional limitations, factors related to psychiatric disorder, and healthcare use on the need for interventions. In total, 44.9% of the patients (mean age 44.9 years) reported somatic symptoms affecting daily life; 87.6% needed specific interventions for a disease or condition, most commonly for cardiovascular, dermatological, dental, ophthalmological, and gastrointestinal conditions, and for altered glucose homeostasis. Smoking and obesity predicted significantly a need of any intervention, but the predictors varied in each disease category. Strikingly, use of general practitioner services during the previous year did not reduce the need for interventions. Health examinations for outpatients with schizophrenia revealed numerous physical healthcare needs. The health examinations for patients with schizophrenia should contain a medical history taking and a physical examination, in addition to basic measurements and laboratory tests. Prevention and treatment of obesity and smoking should be given priority in order to diminish somatic comorbidities in schizophrenia.

  18. Relationship of physical examination test of shoulder instability to arthroscopic findings in dogs.

    Science.gov (United States)

    Devitt, Chad M; Neely, Marlon R; Vanvechten, Brian J

    2007-10-01

    To determine the diagnostic validity of commonly used physical examination maneuvers for shoulder instability. Retrospective study. Dogs (n=24) referred for shoulder arthroscopy. Results of physical maneuvers and arthroscopic findings were recorded and sensitivity, specificity, positive likelihood ratios (LR+), and negative likelihood ratios (LR-) were calculated for each of 4 physical examination test findings for arthroscopic changes in the medial, lateral, cranial, or caudal compartments of the shoulder joint viewed in dorsal recumbency by lateral and craniomedial portals. Distribution of compartment changes was: medial (17 dogs), caudal (15), cranial (12), and lateral (5). The biceps test had a moderate effect (LR+=9) on post-test probability of cranial compartment changes and a small effect on post-test probability of lateral and caudal compartment changes (LR+=3 and 2.4, respectively). Hyperabduction had a minimal effect and mediolateral instability test had a small effect (LR+=1.64 and 2.68, respectively) on post-test probability of medial compartment changes. Craniocaudal instability test had little to no effect on post-test probability of changes in any compartment. Physical examination tests evaluated were limited in their ability to predict the type of arthroscopic pathology in this study population. Clinicians should understand that a diagnostic test performs inconsistently based on prevalence of a condition in a given patient population. The use of likelihood ratios can assist clinicians in determining the probability of intraarticular changes from a group with a differing prevalence than the patient population presented.

  19. Using the Physical Examination to Diagnose Patients with Acute Dizziness and Vertigo.

    Science.gov (United States)

    Edlow, Jonathan A; Newman-Toker, David

    2016-04-01

    Emergency department (ED) patients who present with acute dizziness or vertigo can be challenging to diagnose. Roughly half have general medical disorders that are usually apparent from the context, associated symptoms, or initial laboratory tests. The rest include a mix of common inner ear disorders and uncommon neurologic ones, particularly vertebrobasilar strokes or posterior fossa mass lesions. In these latter cases, misdiagnosis can lead to serious adverse consequences for patients. Our aim was to assist emergency physicians to use the physical examination effectively to make a specific diagnosis in patients with acute dizziness or vertigo. Recent evidence indicates that the physical examination can help physicians accurately discriminate between benign inner ear conditions and dangerous central ones, enabling correct management of peripheral vestibular disease and avoiding dangerous misdiagnoses of central ones. Patients with the acute vestibular syndrome mostly have vestibular neuritis, but some have stroke. Data suggest that focused eye movement examinations, at least when performed by specialists, are more sensitive for detecting early stroke than brain imaging, including diffusion-weighted magnetic resonance imaging. Patients with the triggered episodic vestibular syndrome mostly have benign paroxysmal positional vertigo (BPPV), but some have posterior fossa mass lesions. Specific positional tests to provoke nystagmus can confirm a BPPV diagnosis at the bedside, enabling immediate curative therapy, or indicate the need for imaging. Emergency physicians can effectively use the physical examination to make a specific diagnosis in patients with acute dizziness or vertigo. They must understand the limitations of brain imaging. This may reduce misdiagnosis of serious central causes of dizziness, including posterior circulation stroke and posterior fossa mass lesions, and improve resource utilization. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Respiratory mechanics

    CERN Document Server

    Wilson, Theodore A

    2016-01-01

    This book thoroughly covers each subfield of respiratory mechanics: pulmonary mechanics, the respiratory pump, and flow. It presents the current understanding of the field and serves as a guide to the scientific literature from the golden age of respiratory mechanics, 1960 - 2010. Specific topics covered include the contributions of surface tension and tissue forces to lung recoil, the gravitational deformation of the lung, and the interdependence forces that act on pulmonary airways and blood vessels. The geometry and kinematics of the ribs is also covered in detail, as well as the respiratory action of the external and internal intercostal muscles, the mechanics of the diaphragm, and the quantitative compartmental models of the chest wall is also described. Additionally, flow in the airways is covered thoroughly, including the wave-speed and viscous expiratory flow-limiting mechanisms; convection, diffusion and the stationary front; and the distribution of ventilation. This is an ideal book for respiratory ...

  1. Respiratory signal analysis of liver cancer patients with respiratory-gated radiation therapy

    International Nuclear Information System (INIS)

    Kang, Dong Im; Jung, Sang Hoon; Kim, Chul Jong; Park, Hee Chul; Choi, Byung Ki

    2015-01-01

    External markers respiratory movement measuring device (RPM; Real-time Position Management, Varian Medical System, USA) Liver Cancer Radiation Therapy Respiratory gated with respiratory signal with irradiation time and the actual research by analyzing the respiratory phase with the breathing motion measurement device respiratory tuning evaluate the accuracy of radiation therapy May-September 2014 Novalis Tx. (Varian Medical System, USA) and liver cancer radiotherapy using respiratory gated RPM (Duty Cycle 20%, Gating window 40%-60%) of 16 patients who underwent total when recording the analyzed respiratory movement. After the breathing motion of the external markers recorded on the RPM was reconstructed by breathing through the acts phase analysis, for Beam-on Time and Duty Cycle recorded by using the reconstructed phase breathing breathing with RPM gated the prediction accuracy of the radiation treatment analysis and analyzed the correlation between prediction accuracy and Duty Cycle in accordance with the reproducibility of the respiratory movement. Treatment of 16 patients with respiratory cycle during the actual treatment plan was analyzed with an average difference -0.03 seconds (range -0.50 seconds to 0.09 seconds) could not be confirmed statistically significant difference between the two breathing (p = 0.472). The average respiratory period when treatment is 4.02 sec (0.71 sec), the average value of the respiratory cycle of the treatment was characterized by a standard deviation 7.43% (range 2.57 to 19.20%). Duty Cycle is that the actual average 16.05% (range 13.78 to 17.41%), average 56.05 got through the acts of the show and then analyzed% (range 39.23 to 75.10%) is planned in respiratory research phase (40% to 60%) in was confirmed. The investigation on the correlation between the ratio Duty Cycle and planned respiratory phase and the standard deviation of the respiratory cycle was analyzed in each -0.156 (p = 0.282) and -0.385 (p = 0.070). This study is

  2. Continuous physical examination during subcortical resection in awake craniotomy patients: Its usefulness and surgical outcome.

    Science.gov (United States)

    Bunyaratavej, Krishnapundha; Sangtongjaraskul, Sunisa; Lerdsirisopon, Surunchana; Tuchinda, Lawan

    2016-08-01

    To evaluate the value of physical examination as a monitoring tool during subcortical resection in awake craniotomy patients and surgical outcomes. Authors reviewed medical records of patients underwent awake craniotomy with continuous physical examination for pathology adjacent to the eloquent area. Between January 2006 and August 2015, there were 37 patients underwent awake craniotomy with continuous physical examination. Pathology was located in the left cerebral hemisphere in 28 patients (75.7%). Thirty patients (81.1%) had neuroepithelial tumors. Degree of resections were defined as total, subtotal, and partial in 16 (43.2%), 11 (29.7%) and 10 (27.0%) patients, respectively. Median follow up duration was 14 months. The reasons for termination of subcortical resection were divided into 3 groups as follows: 1) by anatomical landmark with the aid of neuronavigation in 20 patients (54%), 2) by reaching subcortical stimulation threshold in 8 patients (21.6%), and 3) by abnormal physical examination in 9 patients (24.3%). Among these 3 groups, there were statistically significant differences in the intraoperative (p=0.002) and early postoperative neurological deficit (p=0.005) with the lowest deficit in neuronavigation group. However, there were no differences in neurological outcome at later follow up (3-months p=0.103; 6-months p=0.285). There were no differences in the degree of resection among the groups. Continuous physical examination has shown to be of value as an additional layer of monitoring of subcortical white matter during resection and combining several methods may help increase the efficacy of mapping and monitoring of subcortical functions. Copyright © 2016 Elsevier B.V. All rights reserved.

  3. Incidence of respiratory viruses in Peruvian children with acute respiratory infections.

    Science.gov (United States)

    del Valle Mendoza, Juana; Cornejo-Tapia, Angela; Weilg, Pablo; Verne, Eduardo; Nazario-Fuertes, Ronald; Ugarte, Claudia; del Valle, Luis J; Pumarola, Tomás

    2015-06-01

    Acute respiratory infections are responsible for high morbi-mortality in Peruvian children. However, the etiological agents are poorly identified. This study, conducted during the pandemic outbreak of H1N1 influenza in 2009, aims to determine the main etiological agents responsible for acute respiratory infections in children from Lima, Peru. Nasopharyngeal swabs collected from 717 children with acute respiratory infections between January 2009 and December 2010 were analyzed by multiplex RT-PCR for 13 respiratory viruses: influenza A, B, and C virus; parainfluenza virus (PIV) 1, 2, 3, and 4; and human respiratory syncytial virus (RSV) A and B, among others. Samples were also tested with direct fluorescent-antibodies (DFA) for six respiratory viruses. RT-PCR and DFA detected respiratory viruses in 240 (33.5%) and 85 (11.9%) cases, respectively. The most common etiological agents were RSV-A (15.3%), followed by influenza A (4.6%), PIV-1 (3.6%), and PIV-2 (1.8%). The viruses identified by DFA corresponded to RSV (5.9%) and influenza A (1.8%). Therefore, respiratory syncytial viruses (RSV) were found to be the most common etiology of acute respiratory infections. The authors suggest that active surveillance be conducted to identify the causative agents and improve clinical management, especially in the context of possible circulation of pandemic viruses. © 2015 Wiley Periodicals, Inc.

  4. The microbiota of the respiratory tract : Gatekeeper to respiratory health

    NARCIS (Netherlands)

    Man, Wing Ho; De Steenhuijsen Piters, Wouter A.A.; Bogaert, Debby

    2017-01-01

    The respiratory tract is a complex organ system that is responsible for the exchange of oxygen and carbon dioxide. The human respiratory tract spans from the nostrils to the lung alveoli and is inhabited by niche-specific communities of bacteria. The microbiota of the respiratory tract probably acts

  5. The Stress-Metabolic Syndrome Relationship in Adolescents: An Examination of the Moderating Potential of Physical Activity.

    Science.gov (United States)

    Holmes, Megan E; Pivarnik, Jim; Pfeiffer, Karin; Maier, Kimberly S; Eisenmann, Joey C; Ewing, Martha

    2016-10-01

    The role of psychosocial stress in the development of obesity and metabolic syndrome is receiving increased attention and has led to examination of whether physical activity may moderate the stress-metabolic syndrome relationship. The current study examined relationships among physical activity, stress, and metabolic syndrome in adolescents. Participants (N = 126; 57 girls, 69 boys) were assessed for anthropometry, psychosocial stress, physical activity, and metabolic syndrome variables; t tests were used to examine sex differences, and regression analysis was used to assess relationships among variables controlling for sex and maturity status. Mean body mass index approached the 75th percentile for both sexes. Typical sex differences were observed for systolic blood pressure, time spent in moderate and vigorous physical activity, and perceived stress. Although stress was not associated with MetS (β = -.001, P = .82), a modest, positive relationship was observed with BMI (β = .20, P = .04). Strong relationships between physical activity and stress with MetS or BMI were not found in this sample. Results may be partially explained by overall good physical health status of the participants. Additional research in groups exhibiting varying degrees of health is needed.

  6. Inadequacies of Physical Examination as a Cause of Medical Errors and Adverse Events: A Collection of Vignettes.

    Science.gov (United States)

    Verghese, Abraham; Charlton, Blake; Kassirer, Jerome P; Ramsey, Meghan; Ioannidis, John P A

    2015-12-01

    Oversights in the physical examination are a type of medical error not easily studied by chart review. They may be a major contributor to missed or delayed diagnosis, unnecessary exposure to contrast and radiation, incorrect treatment, and other adverse consequences. Our purpose was to collect vignettes of physical examination oversights and to capture the diversity of their characteristics and consequences. A cross-sectional study using an 11-question qualitative survey for physicians was distributed electronically, with data collected from February to June of 2011. The participants were all physicians responding to e-mail or social media invitations to complete the survey. There were no limitations on geography, specialty, or practice setting. Of the 208 reported vignettes that met inclusion criteria, the oversight was caused by a failure to perform the physical examination in 63%; 14% reported that the correct physical examination sign was elicited but misinterpreted, whereas 11% reported that the relevant sign was missed or not sought. Consequence of the physical examination inadequacy included missed or delayed diagnosis in 76% of cases, incorrect diagnosis in 27%, unnecessary treatment in 18%, no or delayed treatment in 42%, unnecessary diagnostic cost in 25%, unnecessary exposure to radiation or contrast in 17%, and complications caused by treatments in 4%. The mode of the number of physicians missing the finding was 2, but many oversights were missed by many physicians. Most oversights took up to 5 days to identify, but 66 took longer. Special attention and skill in examining the skin and its appendages, as well as the abdomen, groin, and genitourinary area could reduce the reported oversights by half. Physical examination inadequacies are a preventable source of medical error, and adverse events are caused mostly by failure to perform the relevant examination. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Examining problem solving in physics-intensive Ph.D. research

    Directory of Open Access Journals (Sweden)

    Anne E. Leak

    2017-07-01

    Full Text Available Problem-solving strategies learned by physics undergraduates should prepare them for real-world contexts as they transition from students to professionals. Yet, graduate students in physics-intensive research face problems that go beyond problem sets they experienced as undergraduates and are solved by different strategies than are typically learned in undergraduate coursework. This paper expands the notion of problem solving by characterizing the breadth of problems and problem-solving processes carried out by graduate students in physics-intensive research. We conducted semi-structured interviews with ten graduate students to determine the routine, difficult, and important problems they engage in and problem-solving strategies they found useful in their research. A qualitative typological analysis resulted in the creation of a three-dimensional framework: context, activity, and feature (that made the problem challenging. Problem contexts extended beyond theory and mathematics to include interactions with lab equipment, data, software, and people. Important and difficult contexts blended social and technical skills. Routine problem activities were typically well defined (e.g., troubleshooting, while difficult and important ones were more open ended and had multiple solution paths (e.g., evaluating options. In addition to broadening our understanding of problems faced by graduate students, our findings explore problem-solving strategies (e.g., breaking down problems, evaluating options, using test cases or approximations and characteristics of successful problem solvers (e.g., initiative, persistence, and motivation. Our research provides evidence of the influence that problems students are exposed to have on the strategies they use and learn. Using this evidence, we have developed a preliminary framework for exploring problems from the solver’s perspective. This framework will be examined and refined in future work. Understanding problems

  8. Examining problem solving in physics-intensive Ph.D. research

    Science.gov (United States)

    Leak, Anne E.; Rothwell, Susan L.; Olivera, Javier; Zwickl, Benjamin; Vosburg, Jarrett; Martin, Kelly Norris

    2017-12-01

    Problem-solving strategies learned by physics undergraduates should prepare them for real-world contexts as they transition from students to professionals. Yet, graduate students in physics-intensive research face problems that go beyond problem sets they experienced as undergraduates and are solved by different strategies than are typically learned in undergraduate coursework. This paper expands the notion of problem solving by characterizing the breadth of problems and problem-solving processes carried out by graduate students in physics-intensive research. We conducted semi-structured interviews with ten graduate students to determine the routine, difficult, and important problems they engage in and problem-solving strategies they found useful in their research. A qualitative typological analysis resulted in the creation of a three-dimensional framework: context, activity, and feature (that made the problem challenging). Problem contexts extended beyond theory and mathematics to include interactions with lab equipment, data, software, and people. Important and difficult contexts blended social and technical skills. Routine problem activities were typically well defined (e.g., troubleshooting), while difficult and important ones were more open ended and had multiple solution paths (e.g., evaluating options). In addition to broadening our understanding of problems faced by graduate students, our findings explore problem-solving strategies (e.g., breaking down problems, evaluating options, using test cases or approximations) and characteristics of successful problem solvers (e.g., initiative, persistence, and motivation). Our research provides evidence of the influence that problems students are exposed to have on the strategies they use and learn. Using this evidence, we have developed a preliminary framework for exploring problems from the solver's perspective. This framework will be examined and refined in future work. Understanding problems graduate students

  9. Respiratory symptoms and lung function in bauxite miners.

    Science.gov (United States)

    Beach, J R; de Klerk, N H; Fritschi, L; Sim, M R; Musk, A W; Benke, G; Abramson, M J; McNeil, J J

    2001-09-01

    To determine whether cumulative bauxite exposure is associated with respiratory symptoms or changes in lung function in a group of bauxite miners. Current employees at three bauxite mines in Australia were invited to participate in a survey comprising: questionnaire on demographic details, respiratory symptoms, and work history; skin prick tests for four common aeroallergens; and spirometry. A task exposure matrix was constructed for bauxite exposure in all tasks in all jobs based on monitoring data. Data were examined for associations between cumulative bauxite exposure, and respiratory symptoms and lung function, by regression analyses. The participation rate was 86%. Self-reported work-related respiratory symptoms were reported by relatively few subjects (1.5%-11.8%). After adjustment for age and smoking no significant differences in the prevalence of respiratory symptoms were identified between subjects, in the quartiles of cumulative bauxite exposure distribution. The forced expiratory volume in I s (FEV1) of the exposed group was found to be significantly lower than that for the unexposed group. After adjustment for age, height, and smoking there were no statistically significant differences between quartiles in FEVI, forced vital capacity (FVC) and FEVl/FVC ratio. These data provide little evidence of a serious adverse effect on respiratory health associated with exposure to bauxite in an open-cut bauxite mine in present day conditions.

  10. Instantaneous Respiratory Estimation from Thoracic Impedance by Empirical Mode Decomposition

    Directory of Open Access Journals (Sweden)

    Fu-Tai Wang

    2015-07-01

    Full Text Available Impedance plethysmography provides a way to measure respiratory activity by sensing the change of thoracic impedance caused by inspiration and expiration. This measurement imposes little pressure on the body and uses the human body as the sensor, thereby reducing the need for adjustments as body position changes and making it suitable for long-term or ambulatory monitoring. The empirical mode decomposition (EMD can decompose a signal into several intrinsic mode functions (IMFs that disclose nonstationary components as well as stationary components and, similarly, capture respiratory episodes from thoracic impedance. However, upper-body movements usually produce motion artifacts that are not easily removed by digital filtering. Moreover, large motion artifacts disable the EMD to decompose respiratory components. In this paper, motion artifacts are detected and replaced by the data mirrored from the prior and the posterior before EMD processing. A novel intrinsic respiratory reconstruction index that considers both global and local properties of IMFs is proposed to define respiration-related IMFs for respiration reconstruction and instantaneous respiratory estimation. Based on the experiments performing a series of static and dynamic physical activates, our results showed the proposed method had higher cross correlations between respiratory frequencies estimated from thoracic impedance and those from oronasal airflow based on small window size compared to the Fourier transform-based method.

  11. Respiratory Home Health Care

    Science.gov (United States)

    ... Us Home > Healthy Living > Living With Lung Disease > Respiratory Home Health Care Font: Aerosol Delivery Oxygen Resources ... Teenagers Living With Lung Disease Articles written by Respiratory Experts Respiratory Home Health Care Respiratory care at ...

  12. Spirometry and impulse oscillometry (IOS) for detection of respiratory abnormalities in metropolitan firefighters.

    NARCIS (Netherlands)

    Schermer, T.R.J.; Malbon, W.; Newbury, W.; Holton, C.; Smith, M.; Morgan, M.; Crockett, A.

    2010-01-01

    BACKGROUND AND OBJECTIVE: As firefighters are at increased risk of adverse health effects, periodic examination of their respiratory health is important. The objective of this study was to establish whether the use of impulse oscillometry (IOS) reveals respiratory abnormalities in metropolitan

  13. Respiratory care manpower issues.

    Science.gov (United States)

    Mathews, Paul; Drumheller, Lois; Carlow, John J

    2006-03-01

    Although respiratory care is a relatively new profession, its practitioners are deeply involved in providing patient care in the critical care. In preparation for writing this article, we sought to explore the respiratory therapy manpower needs and activities designed to fulfill those needs in critical care practice. We began by delineating the historical development of respiratory care as a profession, the development of its education, and the professional credentialing system. We then conducted several literature reviews with few articles generated. We requested and received data from the American Association for Respiratory Care (AARC), The National Board for Respiratory Care (NBRC), and the Committee on Accreditation of Respiratory Care education (CoARC) relative to their membership, number of credentialed individuals, and educational program student and graduate data for 2000 through 2004. We then conducted two electronic surveys. Survey 1 was a six-item survey that examined the use of mandatory overtime in respiratory care departments. We used a convenience sample of 30 hospitals stratified by size (or=500 beds). Survey 2 was a five-item instrument distributed by blast E-mail to the Society of Critical Care Medicine's Respiratory Care Section members and members of the RC_World list serve. This survey elicited 51 usable and non-duplicative responses from geographically and size-varied institutions. We analyzed these data in several ways from distribution analysis to one-way analysis of variance procedure and appropriate post hoc analysis techniques. Where appropriate, a matched-pairs analysis was performed and these were compared across the variables intensive care unit (ICU) beds per actual number of respiratory care practitioners (RCPs) and ICU beds per preferred number of RCPs. The data gathered from the professional organizations indicated a relatively stable attrition rate (35.2%+/-1.7-3.1%), even in the face of varying enrollments (6,231 in 2004 vs. 4

  14. Can Physical Examination Create a Stener Lesion?

    Science.gov (United States)

    Lankachandra, Manesha; Eggers, John P; Bogener, James W; Hutchison, Richard L

    2017-09-01

    The purpose of this study is to determine whether a Stener lesion can be created while testing stability of the ulnar collateral ligament (UCL) of the thumb. Testing was performed in a manner that reproduced clinical examination. Six fresh frozen hand and forearm specimens underwent sequential sectioning of the accessory UCL, the proper UCL, and the ulnar sagittal band. Measurements of radial deviation of the metacarpophalangeal (MCP) joint were taken with the thumb in neutral rotation, pronation and supination, both with 0 degrees and with 30 degrees of flexion of the MCP joint. Visual examination was performed to assess the presence of a Stener lesion. No Stener lesion was created in any position as long as the fascial origin of the ulnar sagittal band at the adductor pollicis longus remained intact. After creating a defect in the ulnar sagittal band, a Stener lesion was created in two specimens, but only when the thumb was flexed and supinated. Pronation provided more stability, and supination provided less stability, with one or both components cut, especially when testing at 30° of flexion. Compared to both components cut without flexion or rotation, there was a statistically significant difference in angulation with the 30 degrees of MCP joint flexion in both neutral rotation in supination. Performing a physical examination to assess the amount of instability of an ulnar collateral ligament injury did not create a Stener lesion if the exam was performed in a controlled, gentle manner with the thumb held without rotation. If the thumb is held in neutral rotation during the exam, an iatrogenic Stener lesion should not be created.

  15. Patterns of respiratory illness in Sheffield infant school children

    Energy Technology Data Exchange (ETDEWEB)

    Lunn, J E; Knowelden, J; Handyside, A J

    1967-01-01

    Children were selected for exposure to air pollution within the divergent city of Sheffield. Mean age of children was approx. 5 yr, 4.5 months with range of about 1 yr. Examination included respiratory history, mucopurulent discharge, tonsils, eardrums, FEV/sub 0/ /sub 75/, and FVC. Nasal discharge, history of 3 or more per year, history of colds going to chest, and history of lower respiratory tract illness showed significant variations between lightly and heavily polluted areas. History of frequent cough showed social class correlation. Steadily decreasing FEV with increasing pollution was observed. FVC was lowest in area with highest pollution, but similarly high in other areas. Both parameters were influenced by previous history of respiratory tract disease.

  16. Chronic low back pain in older adults: prevalence, reliability, and validity of physical examination findings.

    Science.gov (United States)

    Weiner, Debra K; Sakamoto, Sara; Perera, Subashan; Breuer, Paula

    2006-01-01

    To develop a structured physical examination protocol that identifies common biomechanical and soft-tissue abnormalities for older adults with chronic low back pain (CLBP) that can be used as a triage tool for healthcare providers and to test the interobserver reliability and discriminant validity of this protocol. Cross-sectional survey and examination. Older adult pain clinic. One hundred eleven community-dwelling adults aged 60 and older with CLBP and 20 who were pain-free. Clinical history for demographics, pain duration, previous lumbar surgery or advanced imaging, neurogenic claudication, and imaging clinically serious symptoms. Physical examination for scoliosis, functional leg length discrepancy, pain with lumbar movement, myofascial pain (paralumbar, piriformis, tensor fasciae latae (TFL)), regional bone pain (sacroiliac joint (SIJ), hip, vertebral body), and fibromyalgia. Scoliosis was prevalent in those with (77.5%) and without pain (60.0%), but prevalence of SIJ pain (84% vs 5%), fibromyalgia tender points (19% vs 0%), myofascial pain (96% vs 10%), and hip pain (48% vs 0%) was significantly different between groups (P physical examination. Their recognition may save unnecessary healthcare expenditure and patient suffering.

  17. EFFECTS OF AIR POLLUTION ON RESPIRATORY HEALTH OF ADULTS IN THREE CHINESE CITIES.

    Science.gov (United States)

    The authors examined potential associations between air-pollution exposures and respiratory symptoms and illnesses of 4,108 adults who resided in 4 districts of 3 large, distinct Chinese cities. Data on respiratory health outcomes and relevant risk factors for parents and childre...

  18. Using respiratory rate and thoracic movement to assess respiratory insufficiency in amyotrophic lateral sclerosis: a preliminary study

    Directory of Open Access Journals (Sweden)

    Siirala Waltteri

    2012-12-01

    Full Text Available Abstract Background Hypoventilation due to respiratory insufficiency is the most common cause of death in amyotrophic lateral sclerosis (ALS and non-invasive ventilation (NIV can be used as a palliative treatment. The current guidelines recommend performing spirometry, and recording nocturnal oxyhemoglobin saturation and arterial blood gas analysis to assess the severity of the hypoventilation. We examined whether the respiratory rate and thoracic movement were reliable preliminary clinical signs in the development of respiratory insufficiency in patients with ALS. Methods We measured the respiratory rate and thoracic movement, performed respiratory function tests and blood gas analysis, and recorded subjective hypoventilation symptoms in 42 ALS patients over a 7-year period. We recommended NIV if the patient presented with hypoventilation matching the current guidelines. We divided patients retrospectively into two groups: those to whom NIV was recommended within 6 months of the diagnosis (Group 1 and those to whom NIV was recommended 6 months after the diagnosis (Group 2. We used the Mann Whitney U test for comparisons between the two groups. Results The mean partial pressure of arterial carbon dioxide in the morning in Group 1 was 6.3 (95% confidence interval 5.6–6.9 kPa and in Group 2 5.3 (5.0–5.6 kPa (p = 0.007. The mean respiratory rate at the time of diagnosis in Group 1 was 21 (18–24 breaths per minute and 16 (14–18 breaths per minute in Group 2 (p = 0.005. The mean thoracic movement was 2.9 (2.2–3.6 cm in Group 1 and 4.0 (3.4–4.8 cm in Group 2 (p = 0.01. We observed no other differences between the groups. Conclusions Patients who received NIV within six months of the diagnosis of ALS had higher respiratory rates and smaller thoracic movement compared with patients who received NIV later. Further studies with larger numbers of patients are needed to establish if these measurements can be used as a marker of hypoventilation

  19. Using respiratory rate and thoracic movement to assess respiratory insufficiency in amyotrophic lateral sclerosis: a preliminary study.

    Science.gov (United States)

    Siirala, Waltteri; Saaresranta, Tarja; Vuori, Arno; Salanterä, Sanna; Olkkola, Klaus T; Aantaa, Riku

    2012-12-27

    Hypoventilation due to respiratory insufficiency is the most common cause of death in amyotrophic lateral sclerosis (ALS) and non-invasive ventilation (NIV) can be used as a palliative treatment. The current guidelines recommend performing spirometry, and recording nocturnal oxyhemoglobin saturation and arterial blood gas analysis to assess the severity of the hypoventilation. We examined whether the respiratory rate and thoracic movement were reliable preliminary clinical signs in the development of respiratory insufficiency in patients with ALS. We measured the respiratory rate and thoracic movement, performed respiratory function tests and blood gas analysis, and recorded subjective hypoventilation symptoms in 42 ALS patients over a 7-year period. We recommended NIV if the patient presented with hypoventilation matching the current guidelines. We divided patients retrospectively into two groups: those to whom NIV was recommended within 6 months of the diagnosis (Group 1) and those to whom NIV was recommended 6 months after the diagnosis (Group 2). We used the Mann Whitney U test for comparisons between the two groups. The mean partial pressure of arterial carbon dioxide in the morning in Group 1 was 6.3 (95% confidence interval 5.6-6.9) kPa and in Group 2 5.3 (5.0-5.6) kPa (p = 0.007). The mean respiratory rate at the time of diagnosis in Group 1 was 21 (18-24) breaths per minute and 16 (14-18) breaths per minute in Group 2 (p = 0.005). The mean thoracic movement was 2.9 (2.2-3.6) cm in Group 1 and 4.0 (3.4-4.8) cm in Group 2 (p = 0.01). We observed no other differences between the groups. Patients who received NIV within six months of the diagnosis of ALS had higher respiratory rates and smaller thoracic movement compared with patients who received NIV later. Further studies with larger numbers of patients are needed to establish if these measurements can be used as a marker of hypoventilation in ALS.

  20. The diagnostic value of history and physical examination for COPD in suspected or known cases: a systematic review.

    Science.gov (United States)

    Broekhuizen, Berna D L; Sachs, Alfred P E; Oostvogels, Rimke; Hoes, Arno W; Verheij, Theo J M; Moons, Karel G M

    2009-08-01

    According to current guidelines, spirometry should be performed in patients suspected of chronic obstructive pulmonary disease (COPD) by the results of history taking and physical examination. However, little is known about the diagnostic value of patient history and physical examination for COPD. To review the existing evidence on the diagnostic value of history taking and physical examination in recognizing COPD in patients suspected of COPD. A systematic literature search was performed in electronic medical databases. Studies were included after using defined inclusion and exclusion criteria and judged on their methodological quality by using the Quality Assessment of Diagnostic Accuracy Studies criteria. A formal meta-analysis was not performed because all studied items of history and physical examination were investigated in only in a maximum of three studies. Six studies were included. The history items dyspnoea, wheezing, previous consultation for wheezing or cough, self-reported COPD, age and smoking and the physical examination items wheezing, forced expiratory time, laryngeal height and prolonged expiration were found to have diagnostic value for COPD. These items were studied in maximally three studies and study population studies were heterogenic. The reference test for COPD in five of the six studies concerned obstructive lung disease in general and not COPD. There is insufficient evidence to assess the value of history taking and physical examination for diagnosing COPD.

  1. Respiratory insufficiency with preserved diaphragmatic function in amyotrophic lateral sclerosis.

    Science.gov (United States)

    Yamauchi, Rika; Imai, Tomihiro; Tsuda, Emiko; Hozuki, Takayoshi; Yamamoto, Daisuke; Shimohama, Shun

    2014-01-01

    We performed a longitudinal study to elucidate the correlation between respiratory insufficiency and respiratory biomarkers, including diaphragmatic compound muscle action potential (DCMAP), at the initiation of noninvasive ventilation (NIV) in patients with amyotrophic lateral sclerosis (ALS). The patients were assessed at least every six months. Additional assessments were performed at the start of respiratory therapy when the patients met the criteria for the initiation of NIV. Each assessment consisted of a full neurological examination, a phrenic nerve conduction study, respiratory function tests, and nocturnal pulsed oximetry. We enrolled 43 patients with either definite or probable ALS as defined by the revised El Escorial criteria. The patients were divided into two groups according to the timing of the initiation of respiratory therapy. Seventeen patients (group A) met the criteria for NIV initiation when their DCMAP remained normal. Twenty-six patients (group B) met the criteria when their DCMAP decreased below normal limits. Although respiratory function parameters were significantly worse in group B compared with group A at NIV initiation, more than 80% of the patients in both groups developed nocturnal desaturation during sleep. DCMAP is not always a reliable indicator for determining the optimal timing for NIV initiation during the progression of respiratory insufficiency in ALS. Physicians should be aware of the risk of respiratory insufficiency during sleep in patients with ALS.

  2. An examination of the effects of mountaintop removal coal mining on respiratory symptoms and COPD using propensity scores.

    Science.gov (United States)

    Hendryx, Michael; Luo, Juhua

    2015-01-01

    Previous research on public health consequences of mountaintop removal (MTR) coal mining has been limited by the observational nature of the data. The current study used propensity scores, a method designed to overcome this limitation, to draw more confident causal inferences about mining effects on respiratory health using non-experimental data. These data come from a health survey of 682 adults residing in two rural areas of Virginia, USA characterized by the presence or absence of MTR mining. Persons with a history of occupational exposure as coal miners were excluded. Nine covariates including age, sex, current and former smoking, overweight, obesity, high school education, college education, and exposure to coal as a home-heating source were selected to estimate propensity scores. Propensity scores were tested for balance and then used as weights to create quasi-experimental exposed and unexposed groups. Results indicated that persons in the mountaintop mining group had significantly (p < 0.0001) elevated prevalence of respiratory symptoms and chronic obstructive pulmonary disease. The results suggest that impaired respiratory health results from exposure to MTR environments and not from other risks.

  3. Changes in respiratory and non-respiratory symptoms in occupants of a large office building over a period of moisture damage remediation attempts

    Science.gov (United States)

    Cho, Sook Ja; White, Sandra K.; Cox-Ganser, Jean M.

    2018-01-01

    There is limited information on the natural history of building occupants’ health in relation to attempts to remediate moisture damage. We examined changes in respiratory and non-respiratory symptoms in 1,175 office building occupants over seven years with multiple remediation attempts. During each of four surveys, we categorized participants using a severity score: 0 = asymptomatic; 1 = mild, symptomatic in the last 12 months, but not frequently in the last 4 weeks; 2 = severe, symptomatic at least once weekly in the last 4 weeks. Building-related symptoms were defined as improving away from the building. We used random intercept models adjusted for demographics, smoking, building tenure, and microbial exposures to estimate temporal changes in the odds of building-related symptoms or severity scores independent of the effect of microbial exposures. Trend analyses of combined mild/severe symptoms showed no changes in the odds of respiratory symptoms but significant improvement in non-respiratory symptoms over time. Separate analyses showed increases in the odds of severe respiratory symptoms (odds ratio/year = 1.15‒1.16, p-valuesremediation efforts might not be effective in improving occupants’ health. PMID:29324816

  4. Intermittent hypoxia, respiratory plasticity and sleep apnea in humans: present knowledge and future investigations.

    Science.gov (United States)

    Mateika, Jason H; Syed, Ziauddin

    2013-09-15

    This review examines the role that respiratory plasticity has in the maintenance of breathing stability during sleep in individuals with sleep apnea. The initial portion of the review considers the manner in which repetitive breathing events may be initiated in individuals with sleep apnea. Thereafter, the role that two forms of respiratory plasticity, progressive augmentation of the hypoxic ventilatory response and long-term facilitation of upper airway and respiratory muscle activity, might have in modifying breathing events in humans is examined. In this context, present knowledge regarding the initiation of respiratory plasticity in humans during wakefulness and sleep is addressed. Also, published findings which reveal that exposure to intermittent hypoxia promotes breathing instability, at least in part, because of progressive augmentation of the hypoxic ventilatory response and the absence of long-term facilitation, are considered. Next, future directions are presented and are focused on the manner in which forms of plasticity that stabilize breathing might be promoted while diminishing destabilizing forms, concurrently. These future directions will consider the potential role of circadian rhythms in the promotion of respiratory plasticity and the role of respiratory plasticity in enhancing established treatments for sleep apnea. Published by Elsevier B.V.

  5. Intermittent hypoxia, respiratory plasticity and sleep apnea in humans; present knowledge and future investigations

    Science.gov (United States)

    Mateika, Jason H.; Syed, Ziauddin

    2013-01-01

    This review examines the role that respiratory plasticity has in the maintenance of breathing stability during sleep in individuals with sleep apnea. The initial portion of the review considers the manner in which repetitive breathing events may be initiated in individuals with sleep apnea. Thereafter, the role that two forms of respiratory plasticity, progressive augmentation of the hypoxic ventilatory response and long-term facilitation of upper airway and respiratory muscle activity, might have in modifying breathing events in humans is examined. In this context, present knowledge regarding the initiation of respiratory plasticity in humans during wakefulness and sleep is addressed. Also, published findings which reveal that exposure to intermittent hypoxia promotes breathing instability, at least in part, because of progressive augmentation of the hypoxic ventilatory response and the absence of long-term facilitation, are considered. Next, future directions are presented and are focused on the manner in which forms of plasticity that stabilize breathing might be promoted while diminishing destabilizing forms, concurrently. These future directions will consider the potential role of circadian rhythms in the promotion of respiratory plasticity and the role of respiratory plasticity in enhancing established treatments for sleep apnea. PMID:23587570

  6. Respiratory Failure

    Science.gov (United States)

    Respiratory failure happens when not enough oxygen passes from your lungs into your blood. Your body's organs, ... brain, need oxygen-rich blood to work well. Respiratory failure also can happen if your lungs can' ...

  7. Respiratory system

    Science.gov (United States)

    Bartlett, R. G., Jr.

    1973-01-01

    The general anatomy and function of the human respiratory system is summarized. Breathing movements, control of breathing, lung volumes and capacities, mechanical relations, and factors relevant to respiratory support and equipment design are discussed.

  8. Computerized Respiratory Sounds: Novel Outcomes for Pulmonary Rehabilitation in COPD.

    Science.gov (United States)

    Jácome, Cristina; Marques, Alda

    2017-02-01

    Computerized respiratory sounds are a simple and noninvasive measure to assess lung function. Nevertheless, their potential to detect changes after pulmonary rehabilitation (PR) is unknown and needs clarification if respiratory acoustics are to be used in clinical practice. Thus, this study investigated the short- and mid-term effects of PR on computerized respiratory sounds in subjects with COPD. Forty-one subjects with COPD completed a 12-week PR program and a 3-month follow-up. Secondary outcome measures included dyspnea, self-reported sputum, FEV 1 , exercise tolerance, self-reported physical activity, health-related quality of life, and peripheral muscle strength. Computerized respiratory sounds, the primary outcomes, were recorded at right/left posterior chest using 2 stethoscopes. Air flow was recorded with a pneumotachograph. Normal respiratory sounds, crackles, and wheezes were analyzed with validated algorithms. There was a significant effect over time in all secondary outcomes, with the exception of FEV 1 and of the impact domain of the St George Respiratory Questionnaire. Inspiratory and expiratory median frequencies of normal respiratory sounds in the 100-300 Hz band were significantly lower immediately (-2.3 Hz [95% CI -4 to -0.7] and -1.9 Hz [95% CI -3.3 to -0.5]) and at 3 months (-2.1 Hz [95% CI -3.6 to -0.7] and -2 Hz [95% CI -3.6 to -0.5]) post-PR. The mean number of expiratory crackles (-0.8, 95% CI -1.3 to -0.3) and inspiratory wheeze occupation rate (median 5.9 vs 0) were significantly lower immediately post-PR. Computerized respiratory sounds were sensitive to short- and mid-term effects of PR in subjects with COPD. These findings are encouraging for the clinical use of respiratory acoustics. Future research is needed to strengthen these findings and explore the potential of computerized respiratory sounds to assess the effectiveness of other clinical interventions in COPD. Copyright © 2017 by Daedalus Enterprises.

  9. Noninvasive Respiratory Management of Patients With Neuromuscular Disease.

    Science.gov (United States)

    Bach, John R

    2017-08-01

    This review article describes definitive noninvasive respiratory management of respiratory muscle dysfunction to eliminate need to resort to tracheotomy. In 2010 clinicians from 22 centers in 18 countries reported 1,623 spinal muscular atrophy type 1 (SMA1), Duchenne muscular dystrophy (DMD), and amyotrophic lateral sclerosis users of noninvasive ventilatory support (NVS) of whom 760 required it continuously (CNVS). The CNVS sustained their lives by over 3,000 patient-years without resort to indwelling tracheostomy tubes. These centers have now extubated at least 74 consecutive ventilator unweanable patients with DMD, over 95% of CNVS-dependent patients with SMA1, and hundreds of others with advanced neuromuscular disorders (NMDs) without resort to tracheotomy. Two centers reported a 99% success rate at extubating 258 ventilator unweanable patients without resort to tracheotomy. Patients with myopathic or lower motor neuron disorders can be managed noninvasively by up to CNVS, indefinitely, despite having little or no measurable vital capacity, with the use of physical medicine respiratory muscle aids. Ventilator-dependent patients can be decannulated of their tracheostomy tubes.

  10. Respiratory Viruses in Febrile Neutropenic Patients with Respiratory Symptoms

    Directory of Open Access Journals (Sweden)

    Mohsen Meidani

    2018-01-01

    Full Text Available Background: Respiratory infections are a frequent cause of fever in neutropenic patients, whereas respiratory viral infections are not frequently considered as a diagnosis, which causes high morbidity and mortality in these patients. Materials and Methods: This prospective study was performed on 36 patients with neutropenia who admitted to hospital were eligible for inclusion with fever (single temperature of >38.3°C or a sustained temperature of >38°C for more than 1 h, upper and lower respiratory symptoms. Sampling was performed from the throat of the patient by the sterile swab. All materials were analyzed by quantitative real-time multiplex polymerase chain reaction covering the following viruses; influenza, parainfluenza virus (PIV, rhinovirus (RV, human metapneumovirus, and respiratory syncytial virus (RSV. Results: RV was the most frequently detected virus and then RSV was the most. PIV was not present in any of the tested samples. Furthermore, no substantial differences in the distribution of specific viral species were observed based on age, sex, neutropenia duration, hematological disorder, and respiratory tract symptoms and signs (P > 0.05. Conclusion: Our prospective study supports the hypothesis that respiratory viruses play an important role in the development of neutropenic fever, and thus has the potential to individualize infection treatment and to reduce the extensive use of antibiotics in immunocompromised patients with neutropenia.

  11. A pilot survey on the quality of life in respiratory rehabilitation carried out in COPD patients with severe respiratory failure: preliminary data of a novel Inpatient Respiratory Rehabilitation Questionnaire (IRRQ

    Directory of Open Access Journals (Sweden)

    Pasqua Franco

    2012-11-01

    Full Text Available Abstract Background Measuring the state of health is a method for quantifying the impact of an illness on the day-to-day life, health and wellbeing of a patient, providing a quantitative measure of an individual’s quality of life (QoL. QoL expresses patient point of view by a subjective dimension and can express the results of medical intervention. Pulmonary rehabilitation is an essential component in the management of COPD patients, and measuring QoL has become a central focus in the study of this disease. Although nowadays several questionnaires for measuring the QoL in COPD patients are available, there are no questionnaires specifically developed for evaluating QoL in COPD patients undergoing respiratory rehabilitation. The aim of this study was to develop a novel questionnaire for the QoL quantification in COPD patients undergoing in-patient pulmonary rehabilitation program. Methods The questionnaire, administered to COPD patients undergoing long-term oxygen therapy into a respiratory rehabilitation ward, was developed by a simple and graphic layout to be administered to elderly patients. It included one form for admission and another for discharge. It included only tips related to the subjective components of QoL that would be relevant for patient, although likely not strictly related to the respiratory function. A descriptive analysis was performed for the socio-demographic characteristics and both the non-parametric Wilcoxon T-test and the Cronbach’s alpha index were calculated for evaluating the sensitivity of the questionnaire to the effects of respiratory rehabilitation and for identifying its consistency. Results The physical and psychological condition of the 34 COPD patients improved after the rehabilitative treatment and this finding was detected by the questionnaire (overall improvement: 14.2±2.5%, as confirmed by the non-parametric Wilcoxon test (p Conclusions This proposed questionnaire represents a substantial innovation

  12. Middle East Respiratory Syndrome

    Centers for Disease Control (CDC) Podcasts

    2014-07-07

    This podcast discusses Middle East Respiratory Syndrome, or MERS, a viral respiratory illness caused by Middle East Respiratory Syndrome Coronavirus—MERS-CoV.  Created: 7/7/2014 by National Center for Immunization and Respiratory Diseases (NCIRD).   Date Released: 7/7/2014.

  13. Subjective neighborhood assessment and physical inactivity: An examination of neighborhood-level variance.

    Science.gov (United States)

    Prochaska, John D; Buschmann, Robert N; Jupiter, Daniel; Mutambudzi, Miriam; Peek, M Kristen

    2018-06-01

    Research suggests a linkage between perceptions of neighborhood quality and the likelihood of engaging in leisure-time physical activity. Often in these studies, intra-neighborhood variance is viewed as something to be controlled for statistically. However, we hypothesized that intra-neighborhood variance in perceptions of neighborhood quality may be contextually relevant. We examined the relationship between intra-neighborhood variance of subjective neighborhood quality and neighborhood-level reported physical inactivity across 48 neighborhoods within a medium-sized city, Texas City, Texas using survey data from 2706 residents collected between 2004 and 2006. Neighborhoods where the aggregated perception of neighborhood quality was poor also had a larger proportion of residents reporting being physically inactive. However, higher degrees of disagreement among residents within neighborhoods about their neighborhood quality was significantly associated with a lower proportion of residents reporting being physically inactive (p=0.001). Our results suggest that intra-neighborhood variability may be contextually relevant in studies seeking to better understand the relationship between neighborhood quality and behaviors sensitive to neighborhood environments, like physical activity. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Risk factors for lower respiratory tract infections in children

    International Nuclear Information System (INIS)

    Silfeler, I.; Tanidir, I.C.

    2012-01-01

    Objectives: Acute respiratory tract infections are divided into two groups as upper and lower respiratory tract infections. These are very common diseases in childhood. In this study, we aimed to determine risk factors for lower respiratory tract in this region. Methodology: Hospital were included in our study. Their examinations, backgrounds, family histories and information about environmental factors were recorded in questionnaire forms. Results: Lack of vaccination, duration of breast feeding, onset age of cow's milk, family history for asthma and food allergy, number of hospitalized people in the same room, number of people who live in same house and smoking around the children were evaluated for the presence of LRTI, and LRTI risks of these factors were respectively observed as 1.69, 1.71, 1.61, 1.69, 1.20, 1.47, 1.56 and 2.63 fold increased. Conclusion: Standardization of clinical diagnosis, accurate and realistic use of antibiotics, correction of nutrition, improvement of socio-economic situation and the elimination of Respiratory Infections. (author)

  15. [Study of etiologic factors of infectious diseases of respiratory tract in school-age children during period of remission of a respiratory disease].

    Science.gov (United States)

    Maĭorov, R V; Chereshneva, M V; Chereshnev, V A

    2013-01-01

    Detect features of microflora of upper respiratory tract on the example of flora of palatine tonsils and level of antibodies against intracellular parasites as markers of etiologic factors of respiratory infections in school-age children in remission period. 466 children from frequently and episodically ill groups were examined. Bacteriologic study of smears from the surface of palatine tonsils was carried out in all the children. By using EIA with the corresponding commercial test systems IgG level against Herpes simplex virus, Cytomegalovirus, Chlamydophila pneumoniae, Mycoplasma pneumoniae, Human respiratory syncytial virus was determined in blood sera according to instruction manual. During remission period of infectious process in the structure of microflora of upper respiratory tract in frequently ill children characteristic differences from their episodically ill peers were detected. In children with frequent respiratory infections a higher occurrence of antibodies against intracellular causative agents of these diseases was also detected. In the group of frequently ill, a direct correlation between frequency of infectious diseases of respiratory tract and occurrence of carriage of pathogenic and opportunistic microorgan isms as well as increase of antibodies against Herpesviridae, Cytomegalovirus, C. pneumoniae and M. pneumoniae was detected. Higher occurrence ofintra- and extra-cellular infectious agents as well as their associations may be considered as one of the reasons of insufficient effectiveness of prophylaxis measures in frequently ill children.

  16. "Heidelberg standard examination" and "Heidelberg standard procedures" - Development of faculty-wide standards for physical examination techniques and clinical procedures in undergraduate medical education.

    Science.gov (United States)

    Nikendei, C; Ganschow, P; Groener, J B; Huwendiek, S; Köchel, A; Köhl-Hackert, N; Pjontek, R; Rodrian, J; Scheibe, F; Stadler, A-K; Steiner, T; Stiepak, J; Tabatabai, J; Utz, A; Kadmon, M

    2016-01-01

    The competent physical examination of patients and the safe and professional implementation of clinical procedures constitute essential components of medical practice in nearly all areas of medicine. The central objective of the projects "Heidelberg standard examination" and "Heidelberg standard procedures", which were initiated by students, was to establish uniform interdisciplinary standards for physical examination and clinical procedures, and to distribute them in coordination with all clinical disciplines at the Heidelberg University Hospital. The presented project report illuminates the background of the initiative and its methodological implementation. Moreover, it describes the multimedia documentation in the form of pocketbooks and a multimedia internet-based platform, as well as the integration into the curriculum. The project presentation aims to provide orientation and action guidelines to facilitate similar processes in other faculties.

  17. Is physical examination required before prescribing hormones to patients with gender dysphoria?

    NARCIS (Netherlands)

    Vardi, Y.; Wylie, K.R.; Moser, C; Assalian, P.; Dean, J.; Asscheman, H.

    2008-01-01

    Introduction. A genital examination can have psychologic effects on a patient, particularly when the source of their sexual medicine complaint is a body part. How necessary is a physical exam before prescribing hormones in cases of gender dsyphoria? Methods. Five people with expertise and/or

  18. Correlation between physical examination and intraoperative findings in shoulder disease treated by arthroscopy. Statistical analysis of 150 patients.

    Science.gov (United States)

    García Parra, P; Anaya Rojas, M; Jiménez Bravo, B; González Oria, M O; Lisbona Muñoz, M; Gil Álvarez, J J; Cano Luis, P

    2016-01-01

    Only a few clinical exploratory manoeuvres are truly discriminatory and useful in shoulder disease. The aim of this study is to correlate the physical examination results of the shoulder with the true diagnosis found by arthroscopy. A retrospective case series of 150 patients with the most common surgical conditions of the shoulder. Data were collected on the suspicion of each pathology, the physical examination of the patient, and the actual discovery of the disease during arthroscopic surgery. The Bankart examination manoeuvres of the lesion show the best results, with a 92.1% positive prediction value (PPV), a 99.1% negative predictive value (NPV), followed by the impingement syndrome, with a PPV of 94.4%, and total cuff rupture with a PPV of 92.3%.Exploration of the superior labrum anterior to posterior (SLAP) lesion had an NPV of 99.1%. Physical examination is sufficient to diagnose or rule out Bankart. A positive physical examination provides the complete rupture of the rotator cuff, and requires further studies. The patients suspected of subacromial syndrome only need an NMR if the physical tests are negative. The conclusions drawn from this work can have a significant impact on both cost savings (by reducing forward tests), and saving time in certain cases in which, after appropriate physical examination, surgery may be indicated without losing time in intermediate steps. Copyright © 2016 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

  19. AIR POLLUTION FROM TRAFFIC AND RESPIRATORY HEALTH

    Directory of Open Access Journals (Sweden)

    Maja Nikolić

    2004-12-01

    Full Text Available Air pollution has very important influence on human health. Earlier investigations were not employed with estimation of influence of air pollution, which spring from traffic, on people health who live near busy cross – road.The aim of this paper was to determine how living near busy cross – road influences on appearance of respiratory symptoms and illness.400 adult people between 18-76 age who live five year least on this location at took a part in investigation. One group (200 live in Nis near the busiest cross-road, another group live in Niska Banja near cross-road with the smallest concentration of pollutants in last five years.We have determined that examines, who live near busy cross – road had statistical signify greater prevalence of all respiratory symptoms and pneumonia.Our investigation showed that living near busy cross road present risk factor for appearance of respiratory symptoms and pneumonia.

  20. Sulfur mustard and respiratory diseases.

    Science.gov (United States)

    Tang, Feng Ru; Loke, Weng Keong

    2012-09-01

    Victims exposed to sulfur mustard (HD) in World War I and Iran-Iraq war, and those suffered occupational or accidental exposure have endured discomfort in the respiratory system at early stages after exposure, and marked general physical deterioration at late stages due to pulmonary fibrosis, bronchiolitis obliterans or lung cancer. At molecule levels, significant changes of cytokines and chemokines in bronchoalveolar lavage and serum, and of selectins (in particular sE-selectin) and soluble Fas ligand in the serum have been reported in recent studies of patients exposed to HD in Iran-Iraq war, suggesting that these molecules may be associated with the pathophysiological development of pulmonary diseases. Experimental studies in rodents have revealed that reactive oxygen and nitrogen species, their product peroxynitrite (ONOO(-)), nitric oxide synthase, glutathione, poly (adenosine diphosphate-ribose) polymerase, activating protein-1 signaling pathway are promising drug targets for preventing HD-induced toxicity, whereas N-acetyl cysteine, tocopherols, melatonin, aprotinin and many other molecules have been proved to be effective in prevention of HD-induced damage to the respiratory system in different animal models. In this paper, we will systemically review clinical and pathophysiological changes of respiratory system in victims exposed to HD in the last century, update clinicians and researchers on the mechanism of HD-induced acute and chronic lung damages, and on the relevant drug targets for future development of antidotes for HD. Further research directions will also be proposed.

  1. Medial tibial stress syndrome can be diagnosed reliably using history and physical examination.

    Science.gov (United States)

    Winters, M; Bakker, E W P; Moen, M H; Barten, C C; Teeuwen, R; Weir, A

    2017-02-08

    The majority of sporting injuries are clinically diagnosed using history and physical examination as the cornerstone. There are no studies supporting the reliability of making a clinical diagnosis of medial tibial stress syndrome (MTSS). Our aim was to assess if MTSS can be diagnosed reliably, using history and physical examination. We also investigated if clinicians were able to reliably identify concurrent lower leg injuries. A clinical reliability study was performed at multiple sports medicine sites in The Netherlands. Athletes with non-traumatic lower leg pain were assessed for having MTSS by two clinicians, who were blinded to each others' diagnoses. We calculated the prevalence, percentage of agreement, observed percentage of positive agreement (Ppos), observed percentage of negative agreement (Pneg) and Kappa-statistic with 95%CI. Forty-nine athletes participated in this study, of whom 46 completed both assessments. The prevalence of MTSS was 74%. The percentage of agreement was 96%, with Ppos and Pneg of 97% and 92%, respectively. The inter-rater reliability was almost perfect; k=0.89 (95% CI 0.74 to 1.00), phistory and physical examination, in clinical practice and research settings. We also found that concurrent lower leg injuries are common in athletes with MTSS. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  2. Human herpesviruses respiratory infections in patients with acute respiratory distress (ARDS).

    Science.gov (United States)

    Bonizzoli, Manuela; Arvia, Rosaria; di Valvasone, Simona; Liotta, Francesco; Zakrzewska, Krystyna; Azzi, Alberta; Peris, Adriano

    2016-08-01

    Acute respiratory distress syndrome (ARDS) is today a leading cause of hospitalization in intensive care unit (ICU). ARDS and pneumonia are closely related to critically ill patients; however, the etiologic agent is not always identified. The presence of human herpes simplex virus 1, human cytomegalovirus and Epstein-Barr virus in respiratory samples of critically ill patients is increasingly reported even without canonical immunosuppression. The main aim of this study was to better understand the significance of herpesviruses finding in lower respiratory tract of ARDS patients hospitalized in ICU. The presence of this group of herpesviruses, in addition to the research of influenza viruses and other common respiratory viruses, was investigated in respiratory samples from 54 patients hospitalized in ICU, without a known microbiological causative agent. Moreover, the immunophenotype of each patient was analyzed. Herpesviruses DNA presence in the lower respiratory tract seemed not attributable to an impaired immunophenotype, whereas a significant correlation was observed between herpesviruses positivity and influenza virus infection. A higher ICU mortality was significantly related to the presence of herpesvirus infection in the lower respiratory tract as well as to impaired immunophenotype, as patients with poor outcome showed severe lymphopenia, affecting in particular T (CD3+) cells, since the first days of ICU hospitalization. In conclusion, these results indicate that herpesviruses lower respiratory tract infection, which occurs more frequently following influenza virus infection, can be a negative prognostic marker. An independent risk factor for ICU patients with ARDS is an impaired immunophenotype.

  3. Physical development and health status of students of the Vocational Mining School in Belchatow

    Energy Technology Data Exchange (ETDEWEB)

    Baszcynski, J; Karpinski, E; Krysinska, H; Sordyl, E; Szydtowski, A

    1981-01-01

    The paper was aimed at an evaluation of the physical development and health status of pupils of Vocational Mining School -- the future workers of the Brown Coal Mine and Power Station in Belchatow. The study covered 257 pupils aged 15 -- 19. The studies indicated that the physical development of the pupils examined is correct. In some of them the following deviations have been found: arterial hypertension, dental caries, decreased acuity of vision. In most cases the muscular force has been lowered. On the other hand, no pathologies of the respiratory system have been found.

  4. Creb1 regulates late stage mammalian lung development via respiratory epithelial and mesenchymal-independent mechanisms

    Science.gov (United States)

    Antony, N.; McDougall, A. R.; Mantamadiotis, T.; Cole, T. J.; Bird, A. D.

    2016-01-01

    During mammalian lung development, the morphological transition from respiratory tree branching morphogenesis to a predominantly saccular architecture, capable of air-breathing at birth, is dependent on physical forces as well as molecular signaling by a range of transcription factors including the cAMP response element binding protein 1 (Creb1). Creb1−/− mutant mice exhibit complete neonatal lethality consistent with a lack of lung maturation beyond the branching phase. To further define its role in the developing mouse lung, we deleted Creb1 separately in the respiratory epithelium and mesenchyme. Surprisingly, we found no evidence of a morphological lung defect nor compromised neonatal survival in either conditional Creb1 mutant. Interestingly however, loss of mesenchymal Creb1 on a genetic background lacking the related Crem protein showed normal lung development but poor neonatal survival. To investigate the underlying requirement for Creb1 for normal lung development, Creb1−/− mice were re-examined for defects in both respiratory muscles and glucocorticoid hormone signaling, which are also required for late stage lung maturation. However, these systems appeared normal in Creb1−/− mice. Together our results suggest that the requirement of Creb1 for normal mammalian lung morphogenesis is not dependent upon its expression in lung epithelium or mesenchyme, nor its role in musculoskeletal development. PMID:27150575

  5. PROGRAM RATIONALE OF TREATMENT AND PREVENTION IN CHILDREN WITH FREQUENT RESPIRATORY DISEASES

    Directory of Open Access Journals (Sweden)

    A. V. Deryusheva

    2017-01-01

    Full Text Available The results of complex clinical and laboratory examination of 146 children aged 2—3 years attending kindergarten were presented. The leading predictors of frequent respiratory disease: disturbance of microbiocenosis oropharyngeal mucosa, immunoglobulins decrease, respiratory allergic pathology were established and scientifically substantiated. The results obtained prove the main directions of therapeutic and preventive measures.

  6. Loss of CDKL5 disrupts respiratory function in mice.

    Science.gov (United States)

    Lee, Kun-Ze; Liao, Wenlin

    2018-01-01

    Cyclin-dependent kinase-like 5 (CDKL5) is an X-linked gene encoding a serine-threonine kinase that is highly expressed in the central nervous system. Mutations in CDKL5 cause neurological and psychiatric symptoms, including early-onset seizures, motor dysfunction, autistic features and sleep breathing abnormalities in patients. It remains to be addressed whether loss of CDKL5 causes respiratory dysfunction in mice. Here, we examined the respiratory pattern of male Cdkl5 -/y mice at 1-3 months of age during resting breathing and respiratory challenge (i.e., hypoxia and hypercapnia) via whole body plethysmography. The results demonstrated that the resting respiratory frequency and tidal volume of Cdkl5 -/y mice was unaltered compared to that of WT mice at 1 month of age. However, these mutant mice exhibit transient reduction in tidal volume during respiratory challenge even the reduction was restored at 2 months of age. Notably, the sigh-breathing pattern was changed in Cdkl5 -/y mice, showing a transient reduction in sigh volume at 1-2 month of age and long-term attenuation of peak expiratory airflow from 1 to 3 month of age. Therefore, loss of CDKL5 causes breathing deficiency, supporting a CDKL5-mediated regulation of respiratory function in mice. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. [Upper respiratory tract infections and sports].

    Science.gov (United States)

    Boffi El Amari, Emmanuelle

    2010-08-11

    Upper respiratory tract infections are frequent in athletes. Mainly of viral origin, they are treated symptomatically. Infectious mononucleosis is associated with an estimated 2% per hundred risk of splenic rupture, which occurs between day four and twenty one of the illness. Therefore return to play guidelines recommend avoiding, exercice during the first twenty one days. Physical exercise seems to influence the immune system, depending on the intensity and length of it. But the relationship between physical exercise and risk of infections remains controversial: some articles showing an increase in risk, whereas others suggesting a certain degree of protection, in athletes. The actual generally accepted working theory is the J-curve proposed by Nieman. This model remains to be formally proven.

  8. Inhibition of protein kinase A and GIRK channel reverses fentanyl-induced respiratory depression.

    Science.gov (United States)

    Liang, Xiaonan; Yong, Zheng; Su, Ruibin

    2018-06-11

    Opioid-induced respiratory depression is a major obstacle to improving the clinical management of moderate to severe chronic pain. Opioids inhibit neuronal activity via various pathways, including calcium channels, adenylyl cyclase, and potassium channels. Currently, the underlying molecular pathway of opioid-induced respiratory depression is only partially understood. This study aimed to investigate the mechanisms of opioid-induced respiratory depression in vivo by examining the effects of different pharmacological agents on fentanyl-induced respiratory depression. Respiratory parameters were detected using whole body plethysmography in conscious rats. We show that pre-treatment with the protein kinase A (PKA) inhibitor H89 reversed the fentanyl-related effects on respiratory rate, inspiratory time, and expiratory time. Pre-treatment with the G protein-gated inwardly rectifying potassium (GIRK) channel blocker Tertiapin-Q dose-dependently reversed the fentanyl-related effects on respiratory rate and inspiratory time. A phosphodiesterase 4 (PDE4) inhibitor and cyclic adenosine monophosphate (cAMP) analogs did not affect fentanyl-induced respiratory depression. These findings suggest that PKA and GIRK may be involved in fentanyl-induced respiratory depression and could represent useful therapeutic targets for the treatment of fentanyl-induced ventilatory depression. Copyright © 2018 Elsevier B.V. All rights reserved.

  9. Sarcopenia and frailty in chronic respiratory disease

    Science.gov (United States)

    Bone, Anna E; Hepgul, Nilay; Kon, Samantha

    2017-01-01

    Sarcopenia and frailty are geriatric syndromes characterized by multisystem decline, which are related to and reflected by markers of skeletal muscle dysfunction. In older people, sarcopenia and frailty have been used for risk stratification, to predict adverse outcomes and to prompt intervention aimed at preventing decline in those at greatest risk. In this review, we examine sarcopenia and frailty in the context of chronic respiratory disease, providing an overview of the common assessments tools and studies to date in the field. We contrast assessments of sarcopenia, which consider muscle mass and function, with assessments of frailty, which often additionally consider social, cognitive and psychological domains. Frailty is emerging as an important syndrome in respiratory disease, being strongly associated with poor outcome. We also unpick the relationship between sarcopenia, frailty and skeletal muscle dysfunction in chronic respiratory disease and reveal these as interlinked but distinct clinical phenotypes. Suggested areas for future work include the application of sarcopenia and frailty models to restrictive diseases and population-based samples, prospective prognostic assessments of sarcopenia and frailty in relation to common multidimensional indices, plus the investigation of exercise, nutritional and pharmacological strategies to prevent or treat sarcopenia and frailty in chronic respiratory disease. PMID:27923981

  10. Do physical examination and CT-scan measures of femoral neck anteversion and tibial torsion relate to each other?

    Science.gov (United States)

    Sangeux, Morgan; Mahy, Jessica; Graham, H Kerr

    2014-01-01

    Informed clinical decision making for femoral and/or tibial de-rotation osteotomies requires accurate measurement of patient function through gait analysis and anatomy through physical examination of bony torsions. Validity of gait analysis has been extensively studied; however, controversy remains regarding the accuracy of physical examination measurements of femoral and tibial torsion. Comparison between CT-scans and physical examination measurements of femoral neck anteversion (FNA) and external tibial torsion (ETT) were retrospectively obtained for 98 (FNA) and 64 (ETT) patients who attended a tertiary hospital for instrumented gait analysis between 2007 and 2010. The physical examination methods studied for femoral neck anteversion were the trochanteric prominence angle test (TPAT) and the maximum hip rotation arc midpoint (Arc midpoint) and for external tibial torsion the transmalleolar axis (TMA). Results showed that all physical examination measurements statistically differed to the CT-scans (bias(standard deviation): -2(14) for TPAT, -10(12) for Arc midpoint and -16(9) for TMA). Bland and Altman plots showed that method disagreements increased with increasing bony torsions in all cases but notably for TPAT. Regression analysis showed that only TMA and CT-scan measurement of external tibial torsion demonstrated good (R(2)=57%) correlation. Correlations for both TPAT (R(2)=14%) and Arc midpoint (R(2)=39%) with CT-scan measurements of FNA were limited. We conclude that physical examination should be considered as screening techniques rather than definitive measurement methods for FNA and ETT. Further research is required to develop more accurate measurement methods to accompany instrumented gait analysis. Copyright © 2013. Published by Elsevier B.V.

  11. Evaluation of effect of self-examination and physical examination on breast cancer.

    Science.gov (United States)

    Hassan, Lotfi Mohammad; Mahmoud, Noori; Miller, Anthony B; Iraj, Harrirchi; Mohsen, Mirzaei; Majid, Jafarizadea; Reza, Sadeghian Mohammad; Mojgan, Minosepehr

    2015-08-01

    Breast cancer is the number one cancer of women in the world. More than 90% of breast cancers can be cured with early diagnosis followed by effective multimodality treatment. The efficacy of screening by breast self-examination (BSE) and breast physical examination (BPx) is best evaluated using randomized screening trials. A total of 12,660 women aged 35-64 years, 6330 in the intervention group and 6330 in the control group, were randomly selected from four areas of Yazd city, I.R. of Iran. The number of detected cancers along with kind of cancer, staging of cancer, the route of detected cancer and the number of deaths during the first 5 years of the study were collected and analyzed. No significance difference between the two groups was seen in respect to socio-demographic and socio-economic variables (P > 0.05). Subjects in the intervention group had a response rate of 83.5% for attending the health center and 80.2% for visiting the assigned surgeon. A total of 31 and 13 new cases of breast cancer were identified in the intervention and control groups, respectively, of which 48.5% of cases in the intervention group were breast cancer in the two groups with a ratio of 2.4 was observed. BSE & BPx have a significant effect in detecting breast cancers at early stages (<3) suggesting they are effective screening tests with high availability and low costs that can be applied at the community level. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Changes in respiratory and non-respiratory symptoms in occupants of a large office building over a period of moisture damage remediation attempts.

    Science.gov (United States)

    Park, Ju-Hyeong; Cho, Sook Ja; White, Sandra K; Cox-Ganser, Jean M

    2018-01-01

    There is limited information on the natural history of building occupants' health in relation to attempts to remediate moisture damage. We examined changes in respiratory and non-respiratory symptoms in 1,175 office building occupants over seven years with multiple remediation attempts. During each of four surveys, we categorized participants using a severity score: 0 = asymptomatic; 1 = mild, symptomatic in the last 12 months, but not frequently in the last 4 weeks; 2 = severe, symptomatic at least once weekly in the last 4 weeks. Building-related symptoms were defined as improving away from the building. We used random intercept models adjusted for demographics, smoking, building tenure, and microbial exposures to estimate temporal changes in the odds of building-related symptoms or severity scores independent of the effect of microbial exposures. Trend analyses of combined mild/severe symptoms showed no changes in the odds of respiratory symptoms but significant improvement in non-respiratory symptoms over time. Separate analyses showed increases in the odds of severe respiratory symptoms (odds ratio/year = 1.15‒1.16, p-values<0.05) and severity scores (0.02/year, p-values<0.05) for wheezing and shortness of breath on exertion, due to worsening of participants in the mild symptom group. For non-respiratory symptoms, we found no changes in the odds of severe symptoms but improvement in severity scores (-0.04‒-0.01/year, p-values<0.05) and the odds for mild fever and chills, excessive fatigue, headache, and throat symptoms (0.65-0.79/year, p-values<0.05). Our study suggests that after the onset of respiratory and severe non-respiratory symptoms associated with dampness/mold, remediation efforts might not be effective in improving occupants' health.

  13. Neonatal respiratory distress syndrome

    Science.gov (United States)

    Hyaline membrane disease (HMD); Infant respiratory distress syndrome; Respiratory distress syndrome in infants; RDS - infants ... improves slowly after that. Some infants with severe respiratory distress syndrome will die. This most often occurs ...

  14. Activation of respiratory muscles during respiratory muscle training.

    Science.gov (United States)

    Walterspacher, Stephan; Pietsch, Fabian; Walker, David Johannes; Röcker, Kai; Kabitz, Hans-Joachim

    2018-01-01

    It is unknown which respiratory muscles are mainly activated by respiratory muscle training. This study evaluated Inspiratory Pressure Threshold Loading (IPTL), Inspiratory Flow Resistive Loading (IFRL) and Voluntary Isocapnic Hyperpnea (VIH) with regard to electromyographic (EMG) activation of the sternocleidomastoid muscle (SCM), parasternal muscles (PARA) and the diaphragm (DIA) in randomized order. Surface EMG were analyzed at the end of each training session and normalized using the peak EMG recorded during maximum inspiratory maneuvers (Sniff nasal pressure: SnPna, maximal inspiratory mouth occlusion pressure: PImax). 41 healthy participants were included. Maximal activation was achieved for SCM by SnPna; the PImax activated predominantly PARA and DIA. Activations of SCM and PARA were higher in IPTL and VIH than for IFRL (p<0.05). DIA was higher applying IPTL compared to IFRL or VIH (p<0.05). IPTL, IFRL and VIH differ in activation of inspiratory respiratory muscles. Whereas all methods mainly stimulate accessory respiratory muscles, diaphragm activation was predominant in IPTL. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. Predictive Factors of Respiratory Failure in Children with Guillain-Barre Syndrome

    Directory of Open Access Journals (Sweden)

    Nemat Bilan

    2015-03-01

    Full Text Available Introduction:Guillain-Barre Syndrome(GBS is the most common cause of acute flaccid paralysis. Respiratory failure is the most serious short-term complication of GBS and invasive mechanical ventilation is required in 30% of patients.moreover,60% of those who are intubated develop major complications including pnemonia,sepsis,GI bleeding and pulmonary embolism. Thus respiratory failure prediction is crucial. the aim of this study was to determine clinical predictors of respiratory failure to avoid respiratory distress and aspiration.Methods and materials: in a cross sectional and analytical study 140 patients with clinically diagnosis of Guillain-Barre Syndrome were enrolled in study,from october 2008 to october 2014. .demographic data,nerologic examination,cranial nerve and autonomic nervous system involvement, and respiratory failure were recorded prospectively.Results:15 out of 140 patients(10,7% developed respiratory failure and underwent mechanical ventilation.the male/female ratio in patients with respiratory failure and patients without respiratory involvement were (53%/(47% and (54%/(46% respectively(p-value:0.4.the mean age in these two groups were 2,7±1,9 and 5,5±3,2(p-value:0,003.cranial nerve involvement (7,9,10 was recorded in patients with respiratory failure and without respiratory failure54% and25% respectively (p-value:0,03.absent upper limb deep tendon reflexes in these two groups were 70% and 44% respectively.(p-value:0,03 and autonomic nervous system involvement 24% vs. 14%(p-value:0,3.conclusion : our study suggests that younger age , cranial nerve involvement and absent upper limb deep tendon reflexes are predictive factors of respiratory failure in patients with Guillain-Barre Syndrome(GBS.

  16. Respiratory trace feature analysis for the prediction of respiratory-gated PET quantification

    Science.gov (United States)

    Wang, Shouyi; Bowen, Stephen R.; Chaovalitwongse, W. Art; Sandison, George A.; Grabowski, Thomas J.; Kinahan, Paul E.

    2014-02-01

    The benefits of respiratory gating in quantitative PET/CT vary tremendously between individual patients. Respiratory pattern is among many patient-specific characteristics that are thought to play an important role in gating-induced imaging improvements. However, the quantitative relationship between patient-specific characteristics of respiratory pattern and improvements in quantitative accuracy from respiratory-gated PET/CT has not been well established. If such a relationship could be estimated, then patient-specific respiratory patterns could be used to prospectively select appropriate motion compensation during image acquisition on a per-patient basis. This study was undertaken to develop a novel statistical model that predicts quantitative changes in PET/CT imaging due to respiratory gating. Free-breathing static FDG-PET images without gating and respiratory-gated FDG-PET images were collected from 22 lung and liver cancer patients on a PET/CT scanner. PET imaging quality was quantified with peak standardized uptake value (SUVpeak) over lesions of interest. Relative differences in SUVpeak between static and gated PET images were calculated to indicate quantitative imaging changes due to gating. A comprehensive multidimensional extraction of the morphological and statistical characteristics of respiratory patterns was conducted, resulting in 16 features that characterize representative patterns of a single respiratory trace. The six most informative features were subsequently extracted using a stepwise feature selection approach. The multiple-regression model was trained and tested based on a leave-one-subject-out cross-validation. The predicted quantitative improvements in PET imaging achieved an accuracy higher than 90% using a criterion with a dynamic error-tolerance range for SUVpeak values. The results of this study suggest that our prediction framework could be applied to determine which patients would likely benefit from respiratory motion compensation

  17. Respiratory trace feature analysis for the prediction of respiratory-gated PET quantification

    International Nuclear Information System (INIS)

    Wang, Shouyi; Chaovalitwongse, W Art; Bowen, Stephen R; Kinahan, Paul E; Sandison, George A; Grabowski, Thomas J

    2014-01-01

    The benefits of respiratory gating in quantitative PET/CT vary tremendously between individual patients. Respiratory pattern is among many patient-specific characteristics that are thought to play an important role in gating-induced imaging improvements. However, the quantitative relationship between patient-specific characteristics of respiratory pattern and improvements in quantitative accuracy from respiratory-gated PET/CT has not been well established. If such a relationship could be estimated, then patient-specific respiratory patterns could be used to prospectively select appropriate motion compensation during image acquisition on a per-patient basis. This study was undertaken to develop a novel statistical model that predicts quantitative changes in PET/CT imaging due to respiratory gating. Free-breathing static FDG-PET images without gating and respiratory-gated FDG-PET images were collected from 22 lung and liver cancer patients on a PET/CT scanner. PET imaging quality was quantified with peak standardized uptake value (SUV peak ) over lesions of interest. Relative differences in SUV peak between static and gated PET images were calculated to indicate quantitative imaging changes due to gating. A comprehensive multidimensional extraction of the morphological and statistical characteristics of respiratory patterns was conducted, resulting in 16 features that characterize representative patterns of a single respiratory trace. The six most informative features were subsequently extracted using a stepwise feature selection approach. The multiple-regression model was trained and tested based on a leave-one-subject-out cross-validation. The predicted quantitative improvements in PET imaging achieved an accuracy higher than 90% using a criterion with a dynamic error-tolerance range for SUV peak values. The results of this study suggest that our prediction framework could be applied to determine which patients would likely benefit from respiratory motion

  18. Enhancing elderly health examination effectiveness by adding physical function evaluations and interventions.

    Science.gov (United States)

    Li, Chia-Ming; Chang, Ching-I; Yu, Wen-Ruey; Yang, Winnie; Hsu, Chih-Cheng; Chen, Ching-Yu

    This study aimed to assess the benefit of adding physical function evaluations and interventions to routine elderly health examination. This is a Quasi-experimental controlled trial. 404 elderly adults (aged 70 and over) scoring 3-6 on the Canadian Study of Health and Aging Clinical Frailty Scale Chinese In-Person Interview Version (CSHA-CFS) in a 2012 annual elderly health examination were enrolled. Both the control and experimental groups received the routine annual health examination with the latter further provided with functional evaluations, exercise instruction, and nutrition education. 112 (84.8%) persons in the experiment group and 267 (98.2%) in the control group completed the study. CSHA-CFS performance of the experimental group was more likely to improve (odds ratio=9.50, 95% confidence interval (CI)=4.62-19.56) and less likely to deteriorate (OR=0.04, 95% CI=0.01-0.31) one year after intervention. Within the experimental group, Fried Frailty Index improvement percentage surpassed the deterioration percentage (29.5% vs. 0.9%, pPhysical Performance Battery increased from 10.0±1.6 to 11.6±0.9 (pexamination appeared to benefit the health of adults aged 70 years and older. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  19. What Is Respiratory Distress Syndrome?

    Science.gov (United States)

    ... Home / Respiratory Distress Syndrome Respiratory Distress Syndrome Also known as What Is Respiratory ... This condition is called apnea (AP-ne-ah). Respiratory Distress Syndrome Complications Depending on the severity of ...

  20. Correlation between physical examination and three-dimensional gait analysis in the assessment of rotational abnormalities in children with cerebral palsy.

    Science.gov (United States)

    Teixeira, Fernando Borge; Ramalho Júnior, Amancio; Morais Filho, Mauro César de; Speciali, Danielli Souza; Kawamura, Catia Miyuki; Lopes, José Augusto Fernandes; Blumetti, Francesco Camara

    2018-01-01

    Objective To evaluate the correlation between physical examination data concerning hip rotation and tibial torsion with transverse plane kinematics in children with cerebral palsy; and to determine which time points and events of the gait cycle present higher correlation with physical examination findings. Methods A total of 195 children with cerebral palsy seen at two gait laboratories from 2008 and 2016 were included in this study. Physical examination measurements included internal hip rotation, external hip rotation, mid-point hip rotation and the transmalleolar axis angle. Six kinematic parameters were selected for each segment to assess hip rotation and shank-based foot rotation. Correlations between physical examination and kinematic measures were analyzed by Spearman correlation coefficients, and a significance level of 5% was considered. Results Comparing physical examination measurements of hip rotation and hip kinematics, we found moderate to strong correlations for all variables (pphysical examination and hip rotation kinematics (rho range: 0.48-0.61). Moderate correlations were also found between the transmalleolar axis angle measurement on physical examination and foot rotation kinematics (rho range 0.44-0.56; p<0.001). Conclusion These findings may have clinical implications in the assessment and management of transverse plane gait deviations in children with cerebral palsy.

  1. [Physical activity: results of the German Health Interview and Examination Survey for Adults (DEGS1)].

    Science.gov (United States)

    Krug, S; Jordan, S; Mensink, G B M; Müters, S; Finger, J; Lampert, T

    2013-05-01

    Regular physical activity can have a positive effect on health at any age. Today's lifestyles, however, can often be characterised as sedentary. Therefore, the promotion of physical activity and sports has become an integral part of public health measures. The representative data of adults aged 18 to 79 years in Germany obtained from the "German Health Interview and Examination Survey for Adults" (DEGS1) provide an overview of self-estimated current physical activity behaviour. The results show that one third of the adult population claims to pay close attention to reaching a sufficient level of physical activity and one fourth participates in sports for at least 2 h/week on a regular basis. Thus, the percentage of adults regularly engaged in sports has increased compared to the previous "German National Health Interview and Examination Survey 1998". Still, four out of five adults do not achieve at least 2.5 h/week of moderate-intensity physical activity as recommended by the World Health Organisation. Consequently, future individual-level and population-level interventions should focus on target group-specific measures while continuing to promote regular physical activity in all segments of the population. An English full-text version of this article is available at SpringerLink as supplemental.

  2. Risks for upper respiratory infections in infants during their first months in day care included environmental and child-related factors

    DEFF Research Database (Denmark)

    Laursen, Rikke Pilmann; Larnkjær, Anni; Ritz, Christian

    2018-01-01

    AIM: We examined the frequency and potential risk factors for respiratory infections, diarrhoea and absences in infants during their first months in day care. METHODS: This prospective cohort study comprised 269 Danish infants aged 8-14 months and was part of a study that examined how probiotics...... affected absences from day care due to respiratory and gastrointestinal infections. The risk factors examined were the household, child characteristics and type of day care facility. Parents registered upper respiratory tract infections (URTIs), lower respiratory tract infections (LRTIs), diarrhoea and day...... care absences on web-based questionnaires. RESULTS: Over a mean of 5.6 months in day care, 36% and 20% of the infants had at least one URTI or LRTI and 60% had diarrhoeal episodes. The risk of at least one URTI was increased by previous respiratory infections, with an odds ratio (OR) of 2...

  3. Neurological Respiratory Failure

    Directory of Open Access Journals (Sweden)

    Mohan Rudrappa

    2018-01-01

    Full Text Available West Nile virus infection in humans is mostly asymptomatic. Less than 1% of neuro-invasive cases show a fatality rate of around 10%. Acute flaccid paralysis of respiratory muscles leading to respiratory failure is the most common cause of death. Although the peripheral nervous system can be involved, isolated phrenic nerve palsy leading to respiratory failure is rare and described in only two cases in the English literature. We present another case of neurological respiratory failure due to West Nile virus-induced phrenic nerve palsy. Our case reiterates the rare, but lethal, consequences of West Nile virus infection, and the increase of its awareness among physicians.

  4. Tissue artifact removal from respiratory signals based on empirical mode decomposition.

    Science.gov (United States)

    Liu, Shaopeng; Gao, Robert X; John, Dinesh; Staudenmayer, John; Freedson, Patty

    2013-05-01

    On-line measurement of respiration plays an important role in monitoring human physical activities. Such measurement commonly employs sensing belts secured around the rib cage and abdomen of the test object. Affected by the movement of body tissues, respiratory signals typically have a low signal-to-noise ratio. Removing tissue artifacts therefore is critical to ensuring effective respiration analysis. This paper presents a signal decomposition technique for tissue artifact removal from respiratory signals, based on the empirical mode decomposition (EMD). An algorithm based on the mutual information and power criteria was devised to automatically select appropriate intrinsic mode functions for tissue artifact removal and respiratory signal reconstruction. Performance of the EMD-algorithm was evaluated through simulations and real-life experiments (N = 105). Comparison with low-pass filtering that has been conventionally applied confirmed the effectiveness of the technique in tissue artifacts removal.

  5. Respiratory Diseases in University Students Associated with Exposure to Residential Dampness or Mold

    Directory of Open Access Journals (Sweden)

    Mathieu Lanthier-Veilleux

    2016-11-01

    Full Text Available University students are frequently exposed to residential dampness or mold (i.e., visible mold, mold odor, dampness, or water leaks, a well-known contributor to asthma, allergic rhinitis, and respiratory infections. This study aims to: (a describe the prevalence of these respiratory diseases among university students; and (b examine the independent contribution of residential dampness or mold to these diseases. An online survey was conducted in March 2014 among the 26,676 students registered at the Université de Sherbrooke (Quebec, Canada. Validated questions and scores were used to assess self-reported respiratory diseases (i.e., asthma-like symptoms, allergic rhinitis, and respiratory infections, residential dampness or mold, and covariates (e.g., student characteristics. Using logistic regressions, the crude and adjusted odd ratios between residential dampness or mold and self-reported respiratory diseases were examined. Results from the participating students (n = 2097; response rate: 8.1% showed high prevalence of allergic rhinitis (32.6%; 95% CI: 30.6–34.7, asthma-like symptoms (24.0%; 95% CI: 22.1–25.8 and respiratory infections (19.4%; 95% CI: 17.7–21.2. After adjustment, exposure to residential dampness or mold was associated with allergic rhinitis (OR: 1.25; 95% CI: 1.01–1.55 and asthma-like symptoms (OR: 1.70; 95% CI: 1.37–2.11, but not with respiratory infections (OR: 1.07; 95% CI: 0.85–1.36. Among symptomatic students, this exposure was also associated with uncontrolled and burdensome respiratory symptoms (p < 0.01. University students report a high prevalence of allergic rhinitis, asthma-like symptoms and respiratory infections. A common indoor hazard, residential dampness or mold, may play a role in increasing atopic respiratory diseases and their suboptimal control in young adults. These results emphasize the importance for public health organizations to tackle poor housing conditions, especially amongst university

  6. Chemical respiratory allergy: Reverse engineering an adverse outcome pathway

    International Nuclear Information System (INIS)

    Kimber, Ian; Dearman, Rebecca J.; Basketter, David A.; Boverhof, Darrell R.

    2014-01-01

    Allergic sensitisation of the respiratory tract by chemicals is associated with rhinitis and asthma and remains an important occupational health issue. Although less than 80 chemicals have been confirmed as respiratory allergens the adverse health effects can be serious, and in rare instances can be fatal, and there are, in addition, related socioeconomic issues. The challenges that chemical respiratory allergy pose for toxicologists are substantial. No validated methods are available for hazard identification and characterisation, and this is due in large part to the fact that there remains considerable uncertainty and debate about the mechanisms through which sensitisation of the respiratory tract is acquired. Despite that uncertainty, there is a need to establish some common understanding of the key events and processes that are involved in respiratory sensitisation to chemicals and that might in turn provide the foundations for novel approaches to safety assessment. In recent years the concept of adverse outcome pathways (AOP) has gained some considerable interest among the toxicology community as a basis for outlining the key steps leading to an adverse health outcome, while also providing a framework for focusing future research, and for developing alternative paradigms for hazard characterisation. Here we explore application of the same general principles to an examination of the induction by chemicals of respiratory sensitisation. In this instance, however, we have chosen to adopt a reverse engineering approach and to model a possible AOP for chemical respiratory allergy working backwards from the elicitation of adverse health effects to the cellular and molecular mechanisms that are implicated in the acquisition of sensitisation

  7. Severe acute respiratory syndrome (SARS)

    Science.gov (United States)

    SARS; Respiratory failure - SARS ... Complications may include: Respiratory failure Liver failure Heart failure ... 366. McIntosh K, Perlman S. Coronaviruses, including severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS). ...

  8. The reliability of physical examination tests for the diagnosis of anterior cruciate ligament rupture--A systematic review.

    Science.gov (United States)

    Lange, Toni; Freiberg, Alice; Dröge, Patrik; Lützner, Jörg; Schmitt, Jochen; Kopkow, Christian

    2015-06-01

    Systematic literature review. Despite their frequent application in routine care, a systematic review on the reliability of clinical examination tests to evaluate the integrity of the ACL is missing. To summarize and evaluate intra- and interrater reliability research on physical examination tests used for the diagnosis of ACL tears. A comprehensive systematic literature search was conducted in MEDLINE, EMBASE and AMED until May 30th 2013. Studies were included if they assessed the intra- and/or interrater reliability of physical examination tests for the integrity of the ACL. Methodological quality was evaluated with the Quality Appraisal of Reliability Studies (QAREL) tool by two independent reviewers. 110 hits were achieved of which seven articles finally met the inclusion criteria. These studies examined the reliability of four physical examination tests. Intrarater reliability was assessed in three studies and ranged from fair to almost perfect (Cohen's k = 0.22-1.00). Interrater reliability was assessed in all included studies and ranged from slight to almost perfect (Cohen's k = 0.02-0.81). The Lachman test is the physical tests with the highest intrarater reliability (Cohen's k = 1.00), the Lachman test performed in prone position the test with the highest interrater reliability (Cohen's k = 0.81). Included studies were partly of low methodological quality. A meta-analysis could not be performed due to the heterogeneity in study populations, reliability measures and methodological quality of included studies. Systematic investigations on the reliability of physical examination tests to assess the integrity of the ACL are scarce and of varying methodological quality. Copyright © 2014 Elsevier Ltd. All rights reserved.

  9. Total physical activity volume, physical activity intensity, and metabolic syndrome: 1999-2004 National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Churilla, James R; Fitzhugh, Eugene C

    2012-02-01

    This study examined the association of total physical activity volume (TPAV) and physical activity (PA) from three domains [leisure-time physical activity (LTPA), domestic, transportation] with metabolic syndrome. We also investigated the relationship between LTPA intensity and metabolic syndrome risk. Sample included adults who participated in the 1999-2004 National Health and Nutrition Examination Survey. Physical activity measures were created for TPAV, LTPA, domestic PA, and transportational PA. For each, a six-level measure based upon no PA (level 1) and quintiles (levels 2-6) of metabolic equivalents (MET)·min·wk(-1) was created. A three-level variable associated with the current Department of Health and Human Services (DHHS) PA recommendation was also created. SAS and SUDAAN were used for the statistical analysis. Adults reporting the greatest volume of TPAV and LTPA were found to be 36% [odds ratio (OR) 0.64; 95% confidence interval (CI) 0.49-0.83] and 42% (OR 0.58; 95% CI 0.43-0.77), respectively, less likely to have metabolic syndrome. Domestic and transportational PA provided no specific level of protection from metabolic syndrome. Those reporting a TPAV that met the DHHS PA recommendation were found to be 33% (OR 0.67; 95%; CI 0.55-0.83) less likely to have metabolic syndrome compared to their sedentary counterparts. Adults reporting engaging in only vigorous-intensity LTPA were found to be 37% (OR 0.63; 95 CI 0.42-0.96) to 56% (OR 0.44; 95% CI 0.29-0.67) less likely to have metabolic syndrome. Volume, intensity, and domain of PA may all play important roles in reducing the prevalence and risk of metabolic syndrome.

  10. Air-Flow-Driven Triboelectric Nanogenerators for Self-Powered Real-Time Respiratory Monitoring.

    Science.gov (United States)

    Wang, Meng; Zhang, Jiahao; Tang, Yingjie; Li, Jun; Zhang, Baosen; Liang, Erjun; Mao, Yanchao; Wang, Xudong

    2018-06-04

    Respiration is one of the most important vital signs of humans, and respiratory monitoring plays an important role in physical health management. A low-cost and convenient real-time respiratory monitoring system is extremely desirable. In this work, we demonstrated an air-flow-driven triboelectric nanogenerator (TENG) for self-powered real-time respiratory monitoring by converting mechanical energy of human respiration into electric output signals. The operation of the TENG was based on the air-flow-driven vibration of a flexible nanostructured polytetrafluoroethylene (n-PTFE) thin film in an acrylic tube. This TENG can generate distinct real-time electric signals when exposed to the air flow from different breath behaviors. It was also found that the accumulative charge transferred in breath sensing corresponds well to the total volume of air exchanged during the respiration process. Based on this TENG device, an intelligent wireless respiratory monitoring and alert system was further developed, which used the TENG signal to directly trigger a wireless alarm or dial a cell phone to provide timely alerts in response to breath behavior changes. This research offers a promising solution for developing self-powered real-time respiratory monitoring devices.

  11. Iron inhibits respiratory burst of peritoneal phagocytes in vitro

    DEFF Research Database (Denmark)

    Gotfryd, Kamil; Jurek, Aleksandra; Kubit, Piotr

    2011-01-01

    Objective. This study examines the effects of iron ions Fe(3+) on the respiratory burst of phagocytes isolated from peritoneal effluents of continuous ambulatory peritoneal dialysis (CAPD) patients, as an in vitro model of iron overload in end-stage renal disease (ESRD). Material and Methods....... Respiratory burst of peritoneal phagocytes was measured by chemiluminescence method. Results. At the highest used concentration of iron ions Fe(3+) (100 µM), free radicals production by peritoneal phagocytes was reduced by 90% compared to control. Conclusions. Iron overload may increase the risk of infectious...

  12. Respiratory gating in cardiac PET

    DEFF Research Database (Denmark)

    Lassen, Martin Lyngby; Rasmussen, Thomas; Christensen, Thomas E

    2017-01-01

    BACKGROUND: Respiratory motion due to breathing during cardiac positron emission tomography (PET) results in spatial blurring and erroneous tracer quantification. Respiratory gating might represent a solution by dividing the PET coincidence dataset into smaller respiratory phase subsets. The aim...... of our study was to compare the resulting imaging quality by the use of a time-based respiratory gating system in two groups administered either adenosine or dipyridamole as the pharmacological stress agent. METHODS AND RESULTS: Forty-eight patients were randomized to adenosine or dipyridamole cardiac...... stress (82)RB-PET. Respiratory rates and depths were measured by a respiratory gating system in addition to registering actual respiratory rates. Patients undergoing adenosine stress showed a decrease in measured respiratory rate from initial to later scan phase measurements [12.4 (±5.7) vs 5.6 (±4...

  13. Motor function and respiratory capacity in patients with late-onset pompe disease

    DEFF Research Database (Denmark)

    Illes, Zsolt; Mike, Andrea; Trauninger, Anita

    2014-01-01

    Introduction: The relationship between skeletal muscle strength and respiratory dysfunction in Pompe disease has not been examined by quantitative methods. We investigated correlations among lower extremity proximal muscle strength, respiratory function, and motor performance. Methods: Concentric...... strength of the knee extensor and flexor muscles were measured with a dynamometer, and pulmonary function was evaluated using spirometry in 7 adult patients. The six-minute walk test and the four-step stair-climb test were used for assessing aerobic endurance and anaerobic power, respectively. Results......: Anaerobic motor performance correlated with strength of both thigh muscles. Respiratory function did not correlate with either muscle strength or motor function performance. Conclusions: Respiratory and lower extremity proximal muscles could be differentially affected by the disease in individual patients...

  14. Respiratory Therapy for Acute Lung Lesion, by Using Biphasic Positive Pressure Ventilation

    Directory of Open Access Journals (Sweden)

    Yu. V. Marchenkov

    2005-01-01

    Full Text Available Objective. To comparatively study the efficiency of respiratory support in patients with acute lung lesion, by applying BIPAP, SIMV, and aIPPV.Subjects. Twenty-six patients with acute lung lesion whose pattern included acute respiratory distress syndrome (n=16, pneumonia (и=6, and pneumonitis (n=4 were examined. The severity of disease was 18 to 21 APACHE II scale score.Results. The use of BIPAP leads to a better adaptation of a patient to respiratory support, to a reduction in the number of used myorelaxants and sedatives, and to improvement of gas exchange in the lung and diminishes the negative impact of artificial ventilation on hemodynamics. As compared with other types of assisted ventilation, BIPAP accelerates transfer from total respiratory support to spontaneous breathing.

  15. Learning Physical Examination Skills outside Timetabled Training Sessions: What Happens and Why?

    Science.gov (United States)

    Duvivier, Robbert J.; van Geel, Koos; van Dalen, Jan; Scherpbier, Albert J. J. A.; van der Vleuten, Cees P. M.

    2012-01-01

    Lack of published studies on students' practice behaviour of physical examination skills outside timetabled training sessions inspired this study into what activities medical students undertake to improve their skills and factors influencing this. Six focus groups of a total of 52 students from Years 1-3 using a pre-established interview guide.…

  16. Respiratory and metabolic acidosis differentially affect the respiratory neuronal network in the ventral medulla of neonatal rats.

    Science.gov (United States)

    Okada, Yasumasa; Masumiya, Haruko; Tamura, Yoshiyasu; Oku, Yoshitaka

    2007-11-01

    Two respiratory-related areas, the para-facial respiratory group/retrotrapezoid nucleus (pFRG/RTN) and the pre-Bötzinger complex/ventral respiratory group (preBötC/VRG), are thought to play key roles in respiratory rhythm. Because respiratory output patterns in response to respiratory and metabolic acidosis differ, we hypothesized that the responses of the medullary respiratory neuronal network to respiratory and metabolic acidosis are different. To test these hypotheses, we analysed respiratory-related activity in the pFRG/RTN and preBötC/VRG of the neonatal rat brainstem-spinal cord in vitro by optical imaging using a voltage-sensitive dye, and compared the effects of respiratory and metabolic acidosis on these two populations. We found that the spatiotemporal responses of respiratory-related regional activities to respiratory and metabolic acidosis are fundamentally different, although both acidosis similarly augmented respiratory output by increasing respiratory frequency. PreBötC/VRG activity, which is mainly inspiratory, was augmented by respiratory acidosis. Respiratory-modulated pixels increased in the preBötC/VRG area in response to respiratory acidosis. Metabolic acidosis shifted the respiratory phase in the pFRG/RTN; the pre-inspiratory dominant pattern shifted to inspiratory dominant. The responses of the pFRG/RTN activity to respiratory and metabolic acidosis are complex, and involve either augmentation or reduction in the size of respiratory-related areas. Furthermore, the activation pattern in the pFRG/RTN switched bi-directionally between pre-inspiratory/inspiratory and post-inspiratory. Electrophysiological study supported the results of our optical imaging study. We conclude that respiratory and metabolic acidosis differentially affect activities of the pFRG/RTN and preBötC/VRG, inducing switching and shifts of the respiratory phase. We suggest that they differently influence the coupling states between the pFRG/RTN and preBötC/VRG.

  17. Lungs and Respiratory System

    Science.gov (United States)

    ... Videos for Educators Search English Español Lungs and Respiratory System KidsHealth / For Parents / Lungs and Respiratory System ... ll have taken at least 600 million breaths. Respiratory System Basics All of this breathing couldn't ...

  18. Diagnostic strategies using physical examination are minimally useful in defining carpal tunnel syndrome in population-based research studies.

    Science.gov (United States)

    Descatha, A; Dale, A-M; Franzblau, A; Coomes, J; Evanoff, B

    2010-02-01

    We evaluated the utility of physical examination manoeuvres in the prediction of carpal tunnel syndrome (CTS) in a population-based research study. We studied a cohort of 1108 newly employed workers in several industries. Each worker completed a symptom questionnaire, a structured physical examination and nerve conduction study. For each hand, our CTS case definition required both median nerve conduction abnormality and symptoms classified as "classic" or "probable" on a hand diagram. We calculated the positive predictive values and likelihood ratios for physical examination manoeuvres in subjects with and without symptoms. The prevalence of CTS in our cohort was 1.2% for the right hand and 1.0% for the left hand. The likelihood ratios of a positive test for physical provocative tests ranged from 2.0 to 3.3, and those of a negative test from 0.3 to 0.9. The post-test probability of positive testing was study found that physical examination, alone or in combination with symptoms, was not predictive of CTS in a working population. We suggest using specific symptoms as a first-level screening tool, and nerve conduction study as a confirmatory test, as a case definition strategy in research settings.

  19. Extracting a respiratory signal from raw dynamic PET data that contain tracer kinetics.

    Science.gov (United States)

    Schleyer, P J; Thielemans, K; Marsden, P K

    2014-08-07

    Data driven gating (DDG) methods provide an alternative to hardware based respiratory gating for PET imaging. Several existing DDG approaches obtain a respiratory signal by observing the change in PET-counts within specific regions of acquired PET data. Currently, these methods do not allow for tracer kinetics which can interfere with the respiratory signal and introduce error. In this work, we produced a DDG method for dynamic PET studies that exhibit tracer kinetics. Our method is based on an existing approach that uses frequency-domain analysis to locate regions within raw PET data that are subject to respiratory motion. In the new approach, an optimised non-stationary short-time Fourier transform was used to create a time-varying 4D map of motion affected regions. Additional processing was required to ensure that the relationship between the sign of the respiratory signal and the physical direction of movement remained consistent for each temporal segment of the 4D map. The change in PET-counts within the 4D map during the PET acquisition was then used to generate a respiratory curve. Using 26 min dynamic cardiac NH3 PET acquisitions which included a hardware derived respiratory measurement, we show that tracer kinetics can severely degrade the respiratory signal generated by the original DDG method. In some cases, the transition of tracer from the liver to the lungs caused the respiratory signal to invert. The new approach successfully compensated for tracer kinetics and improved the correlation between the data-driven and hardware based signals. On average, good correlation was maintained throughout the PET acquisitions.

  20. Focused Sonographic Examination of the Heart, Lungs and Deep Veins in Acute Admitted Patients with Respiratory Symptoms

    DEFF Research Database (Denmark)

    Laursen, Christian Borbjerg; Sloth, Erik; Lassen, Annmarie Touborg

    2012-01-01

    . Patients were included if one or more of the following symptoms or clinical findings were present: respiratory rate > 20, saturation chest pain. Within one hour after the primary evaluation, focused sonography of the heart, lungs and deep veins...

  1. Effect of transoral tracheal wash on respiratory mechanics in dogs with respiratory disease.

    Science.gov (United States)

    Vaught, Meghan E; Rozanski, Elizabeth A; deLaforcade, Armelle M

    2018-01-01

    The purpose of this study was to determine the impact of a transoral tracheal wash (TOTW) on respiratory mechanics in dogs and to describe the use of a critical care ventilator (CCV) to determine respiratory mechanics. Fourteen client-owned dogs with respiratory diseases were enrolled. Respiratory mechanics, including static compliance (C stat ) and static resistance (R stat ), were determined before and after TOTW. Pre- and post-wash results were compared, with a P -value of mechanics, as observed by a reduction in C stat , presumably due to airway flooding and collapse. While no long-lasting effects were noted in these clinical patients, this effect should be considered when performing TOTW on dogs with respiratory diseases. Respiratory mechanics testing using a CCV was feasible and may be a useful clinical testing approach.

  2. Adolescents' reports of physical violence by peers in residential care settings: an ecological examination.

    Science.gov (United States)

    Khoury-Kassabri, Mona; Attar-Schwartz, Shalhevet

    2014-03-01

    Physical victimization by peers was examined among 1,324 Jewish and Arab adolescents, aged 11 to 19, residing in 32 residential care settings (RCS) for children at-risk in Israel. Hierarchical Linear Modeling (HLM) was used to examine the relationships between physical victimization and adolescents' characteristics (age, gender, self-efficacy, adjustment difficulties, maltreatment by staff, and perceived social climate) as well as institution-level characteristics (care setting type, size, structure, and ethnic affiliation). For this study, we define physical violence as being grabbed, shoved, kicked, punched, hit with a hand, or hit with an object. Over 50% (56%) of the adolescents surveyed reported having experienced at least one form of physical violence by peers. Boys and younger adolescents were more likely to be victimized than girls and older adolescents. The results show that adolescents with adjustment difficulties or low social self-efficacy, and adolescents who perceive an institution's staff as strict and/or had experienced maltreatment by staff, are vulnerable groups for peer victimization. Lower levels of victimization were found in RCS with a familial element than in traditional group settings. Institutions with high concentrations of young people with adjustment difficulties and violent staff behaviors had higher levels of violence among residents. Applying an ecological perspective to an investigation of peer victimization in RCS enables the identification of risk factors at adolescent and institution levels. This type of examination has implications for child welfare practice and policy that can help in the development of prevention and intervention methods designed to tackle the involvement in violence of youth in care.

  3. [A case of respiratory dyskinesia due to clebopride malate].

    Science.gov (United States)

    Kawasaki, H; Yamamoto, M; Okayasu, H; Wakayama, Y

    1991-08-01

    Clebopride malate is therapeutically used for the treatment of peptic ulcer. This drug has potent antidopaminergic activity that causes acute dystonic reaction, parkinsonism and tardive dyskinesia as adverse effects. Here, we have reported an 86-year-old man who developed abnormal involuntary movement of respiratory muscles and lower limb muscles after this drug had been given for four months. This involuntary movement appeared spontaneously at resting state and disappeared during sleep. Surface EMG demonstrated a synchronous grouping discharge in m. orbicularis oris, m. sternocleidomastoideus and m. interstales which synchronized with diaphragmatic movement on cinefluorography. Involuntary movement of the lower limbs was synchronous bilaterally and had little relationship with diaphragmatic movement. This involuntary movement was irregular not only in rhythm but also in duration. According to this irregular nature, we diagnosed this involuntary movement as respiratory dyskinesia with limb dyskinesia that belongs to tardive dyskinesia. After cessation of clebopride malate limb dyskinesia disappeared rapidly and respiratory dyskinesia markedly decreased. We emphasize that respiratory dyskinesia should be differentiated from psychogenic hyperventilation as easily misdiagnosed on initial examination.

  4. Respiratory alkalosis in children with febrile seizures.

    Science.gov (United States)

    Schuchmann, Sebastian; Hauck, Sarah; Henning, Stephan; Grüters-Kieslich, Annette; Vanhatalo, Sampsa; Schmitz, Dietmar; Kaila, Kai

    2011-11-01

    Febrile seizures (FS) are the most common type of convulsive events in children. FS are suggested to result from a combination of genetic and environmental factors. However, the pathophysiologic mechanisms underlying FS remain unclear. Using an animal model of experimental FS, it was demonstrated that hyperthermia causes respiratory alkalosis with consequent brain alkalosis and seizures. Here we examine the acid-base status of children who were admitted to the hospital for FS. Children who were admitted because of gastroenteritis (GE), a condition known to promote acidosis, were examined to investigate a possible protective effect of acidosis against FS. We enrolled 433 age-matched children with similar levels of fever from two groups presented to the emergency department. One group was admitted for FS (n = 213) and the other for GE (n = 220). In the FS group, the etiology of fever was respiratory tract infection (74.2%), otitis media (7%), GE (7%), tonsillitis (4.2%), scarlet fever (2.3%) chickenpox (1.4%), urinary tract infection (1.4%), postvaccination reaction (0.9%), or unidentified (1.4%). In all patients, capillary pH and blood Pco(2) were measured immediately on admission to the hospital. Respiratory alkalosis was found in children with FS (pH 7.46 ± 0.04, [mean ± standard deviation] Pco(2) 29.5 ± 5.5 mmHg), whereas a metabolic acidosis was seen in all children admitted for GE (pH 7.31 ± 0.03, Pco(2) 37.7 ± 4.3 mmHg; p respiratory alkalosis, irrespective of the severity of the underlying infection as indicated by the level of fever. The lack of FS in GE patients is attributable to low pH, which also explains the fact that children with a susceptibility to FS do not have seizures when they have GE-induced fever that is associated with acidosis. The present demonstration of a close link between FS and respiratory alkalosis may pave the way for further clinical studies and attempts to design novel therapies for the treatment of FS by controlling the

  5. Annual physical examination reports vary by gender once teenagers become sexually active

    Science.gov (United States)

    Marcell, Arik V.; Matson, Pam; Ellen, Jonathan M.; Ford, Carol A.

    2010-01-01

    Introduction Few sexually active male adolescents receive sexual/reproductive health (SRH) services. We examine whether the association between adolescents’ sexual behavior status and physical examination over time can help us understand why. Methods We conducted longitudinal cohort analysis of the National Longitudinal Study of Adolescent Health with 9239 adolescents who completed the baseline school (1994/95) and Wave 2 (1996) follow-up surveys approximately 1.5 years later (retention rate=71%). We fit logistic regression models with random effects to estimate individual odds of reporting a physical examination in the past 12 months at follow-up, as compared to baseline, stratified by sexual behavior status and gender, and adjusting for sociodemographic and healthcare access factors. Results 34.5% males and 38.2% females reported experiencing vaginal intercourse by follow-up, and 22.4% males and 24.7% females reported first experiencing intercourse during the study. Among sexually active adolescents, about half reported annual exams and one-fifth no exams. Among females, baseline to follow-up exam reports significantly increased in: sex initiators (adjusted Odds Ratio [95% confidence interval]=2.09 [1.66–2.64]); those reporting sex at both times (2.16 [1.51–3.09]); and those reporting no sex either time (2.47 [2.00–3.04]). Among males, baseline to follow-up exam reports significantly increased in those reporting no sex either time (1.57 [1.26–1.96]) and showed increasing trends in sex initiators (1.27 [0.92–1.76]). Discussion A majority of sexually active adolescents report annual physical exams over time. Providers should not miss opportunities to deliver evidence-based SRH to sexually active adolescents. Future efforts are needed to increase all adolescents’ access to SRH services. PMID:21700156

  6. Respiratory muscle strength in children with mild bronchial asthma disease

    Directory of Open Access Journals (Sweden)

    Kateřina Neumannová

    2017-12-01

    Full Text Available Background: Respiratory muscle strength can be decreased in patients with asthma; however, it is not well-documented whether a mild bronchial asthma disease can affect respiratory muscle strength in children and can be associated with higher presence of breathing difficulties. Objective: The main aim of the present study was to compare respiratory muscle strength between children with asthma and age-matched healthy children. The next aim of this study was to assess the incidence of decreased respiratory muscle strength in children with asthma and healthy children and assess the effect of decreased respiratory muscle strength on the incidence of breathing difficulties. Methods: Children with mild bronchial asthma (n = 167 and age-matched, healthy children (n = 100 were recruited into this study. Pulmonary function tests, maximal inspiratory (PImax and expiratory (PEmax mouth pressures and the incidence of breathing difficulty were evaluated in children with asthma and healthy controls. Results: The inspiratory muscle strength was similar between children with asthma and healthy children. Conversely, the expiratory muscle strength was lower in asthmatic children. There was a statistically significant difference between girls with asthma and healthy girls (PEmax = 81.7 ± 29.8% vs. 100.1 ± 23.7% of predicted, p < .001. PEmax was significantly higher in boys with asthma than in girls with asthma (PEmax = 92.9 ± 26.4 % vs. 81.7 ± 29.8% of predicted, p = .03. A higher incidence of breathing difficulties during physical activity (uphill walking, running, swimming was confirmed in children with asthma with lower respiratory muscle strength. Conclusions: There was a higher prevalence of decreased expiratory muscle strength in children with asthma; therefore, respiratory muscle strength should be tested in these children, especially in those who are symptomatic.

  7. An EEMD-PCA approach to extract heart rate, respiratory rate and respiratory activity from PPG signal.

    Science.gov (United States)

    Motin, Mohammod Abdul; Karmakar, Chandan Kumar; Palaniswami, Marimuthu

    2016-08-01

    The pulse oximeter's photoplethysmographic (PPG) signals, measure the local variations of blood volume in tissues, reflecting the peripheral pulse modulated by cardiac activity, respiration and other physiological effects. Therefore, PPG can be used to extract the vital cardiorespiratory signals like heart rate (HR), respiratory rate (RR) and respiratory activity (RA) and this will reduce the number of sensors connected to the patient's body for recording vital signs. In this paper, we propose an algorithm based on ensemble empirical mode decomposition with principal component analysis (EEMD-PCA) as a novel approach to estimate HR, RR and RA simultaneously from PPG signal. To examine the performance of the proposed algorithm, we used 45 epochs of PPG, electrocardiogram (ECG) and respiratory signal extracted from the MIMIC database (Physionet ATM data bank). The ECG and capnograph based respiratory signal were used as the ground truth and several metrics such as magnitude squared coherence (MSC), correlation coefficients (CC) and root mean square (RMS) error were used to compare the performance of EEMD-PCA algorithm with most of the existing methods in the literature. Results of EEMD-PCA based extraction of HR, RR and RA from PPG signal showed that the median RMS error (quartiles) obtained for RR was 0 (0, 0.89) breaths/min, for HR was 0.62 (0.56, 0.66) beats/min and for RA the average value of MSC and CC was 0.95 and 0.89 respectively. These results illustrated that the proposed EEMD-PCA approach is more accurate in estimating HR, RR and RA than other existing methods.

  8. Insufficient evidence for the use of a physical examination to detect maltreatment in children without prior suspicion: a systematic review.

    Science.gov (United States)

    Hoytema van Konijnenburg, Eva Mm; Teeuw, Arianne H; Sieswerda-Hoogendoorn, Tessa; Leenders, Arnold G E; van der Lee, Johanna H

    2013-12-06

    Although it is often performed in clinical practice, the diagnostic value of a screening physical examination to detect maltreatment in children without prior suspicion has not been reviewed. This article aims to evaluate the diagnostic value of a complete physical examination as a screening instrument to detect maltreatment in children without prior suspicion. We systematically searched the databases of MEDLINE, EMBASE, PsychINFO, CINAHL, and ERIC, using a sensitive search strategy. Studies that i) presented medical findings of a complete physical examination for screening purposes in children 0-18 years, ii) specifically recorded the presence or absence of signs of child maltreatment, and iii) recorded child maltreatment confirmed by a reference standard, were included. Two reviewers independently performed study selection, data extraction, and quality appraisal using the QUADAS-2 tool. The search yielded 4,499 titles, of which three studies met the eligibility criteria. The prevalence of confirmed signs of maltreatment during screening physical examination varied between 0.8% and 13.5%. The designs of the studies were inadequate to assess the diagnostic accuracy of a screening physical examination for child maltreatment. Because of the lack of informative studies, we could not draw conclusions about the diagnostic value of a screening physical examination in children without prior suspicion of child maltreatment.

  9. Clinical history and physical examination skills - A requirement for radiographers?

    International Nuclear Information System (INIS)

    Snaith, Beverly A.; Lancaster, Anne

    2008-01-01

    Radiographer's roles have evolved with their scope broadening over the last 20 years culminating in the development of advanced and consultant posts. Yet one development has not been embraced, despite being inherent in medicine and a common extension of nurse and other allied health professionals' roles, is that of clinical assessment. This article explores the evolving role of the radiographer and discusses whether this should include skills in clinical history taking and physical examination. Issues for education and development will be addressed together with examples of current and potential roles

  10. Household reporting of childhood respiratory health and air pollution in rural Alaska Native communities.

    Science.gov (United States)

    Ware, Desirae N; Lewis, Johnnye; Hopkins, Scarlett; Boyer, Bert; Montrose, Luke; Noonan, Curtis W; Semmens, Erin O; Ward, Tony J

    2014-01-01

    Air pollution is an important contributor to respiratory disease in children. To examine associations between household reporting of childhood respiratory conditions and household characteristics related to air pollution in Alaska Native communities. In-home surveys were administered in 2 rural regions of Alaska. The 12-month prevalence of respiratory conditions was summarized by region and age. Odds ratios (ORs) were calculated to describe associations between respiratory health and household and air quality characteristics. Household-reported respiratory health data were collected for 561 children in 328 households. In 1 region, 33.6% of children aged respiratory infections in children (ORs 1.6-2.5), while reported wheezing was associated with 1 or more smokers living in the household. Reported asthma in 1 region (7.6%) was lower than national prevalence estimates. Findings suggest that there may be preventable exposures, including wood smoke and mould that affect childhood respiratory disease in these rural areas. Additional research is needed to quantify particulate matter 2.5 microns in aerodynamic diameter or less and mould exposures in these communities, and to objectively evaluate childhood respiratory health.

  11. Characteristics of respiratory tract disease in horses inoculated with equine rhinitis A virus.

    Science.gov (United States)

    Diaz-Méndez, Andrés; Hewson, Joanne; Shewen, Patricia; Nagy, Eva; Viel, Laurent

    2014-02-01

    To develop a method for experimental induction of equine rhinitis A virus (ERAV) infection in equids and to determine the clinical characteristics of such infection. 8 ponies (age, 8 to 12 months) seronegative for antibodies against ERAV. PROCEDURES-Nebulization was used to administer ERAV (strain ERAV/ON/05; n = 4 ponies) or cell culture medium (control ponies; 4) into airways of ponies; 4 previously ERAV-inoculated ponies were reinoculated 1 year later. Physical examinations and pulmonary function testing were performed at various times for 21 days after ERAV or mock inoculation. Various types of samples were obtained for virus isolation, blood samples were obtained for serologic testing, and clinical scores were determined for various variables. ERAV-inoculated ponies developed respiratory tract disease characterized by pyrexia, nasal discharge, adventitious lung sounds, and enlarged mandibular lymph nodes. Additionally, these animals had purulent mucus in lower airways up to the last evaluation time 21 days after inoculation (detected endoscopically). The virus was isolated from various samples obtained from lower and upper airways of ERAV-inoculated ponies up to 7 days after exposure; this time corresponded with an increase in serum titers of neutralizing antibodies against ERAV. None of the ponies developed clinical signs of disease after reinoculation 1 year later. Results of this study indicated ERAV induced respiratory tract disease in seronegative ponies. However, ponies with neutralizing antibodies against ERAV did not develop clinical signs of disease when reinoculated with the virus. Therefore, immunization of ponies against ERAV could prevent respiratory tract disease attributable to that virus in such animals.

  12. Respiratory protection standard: comments on OSHA's proposed revision.

    Science.gov (United States)

    Decker, M D

    1995-06-01

    On November 15, 1994, the Occupational Safety and Health Administration (OSHA) published in the Federal Register (59:58884-58956) the draft of a proposed revision of the Respiratory Protection Standard. One of OSHA's oldest standards, the Respiratory Protection Standard defines the conduct of the employer (eg, hospital) with respect to respirator training, fit testing, medical examinations, use, storage, and so on. The proposed revision appears to have been drafted with no consideration for its effect on healthcare workers or the healthcare industry. SHEA has prepared the following comments to OSHA, which have been submitted to the docket and will be presented at public hearings later this month.

  13. The relationship between host factors of allergic nature and respiratory symptoms.

    Science.gov (United States)

    Gepts, L; Minette, A

    1977-01-01

    Respiratory symptoms and personal history of allergy were examined in 1659 children, including the entire elementary school population of four villages of the Belgian Ardennes. Levels of atmospheric pollution were monitored during the survey and proved to be very low. It is suggested that socio-economic factors produce a small increase in respiratory symptoms, particularly in cough symptoms. A personal history of eczema and of hay fever was highly associated with dyspnea and wheezing.

  14. The role of physical examinations in studies of musculoskeletal disorders of the elbow

    DEFF Research Database (Denmark)

    Kryger, Ann Isabel; Lassen, C. F.; Andersen, JH

    2007-01-01

    OBJECTIVES: To present data on pain and physical findings from the elbow region, and to discuss the role of diagnostic criteria in epidemiological studies of epicondylitis. METHODS: From a cohort of computer workers a subgroup of 1369 participants, who reported at least moderate pain in the neck...... completed on the day of examination. RESULTS: 349 participants met the authors' criteria for being an arm case and 249 were elbow cases. Among the 1369 participants the prevalence of at least mild palpation tenderness and indirect tenderness at the lateral epicondyle was 5.8%. The occurrence of physical...... findings increased markedly by level of pain score. Only about one half with physical findings fulfilled the authors' pain criteria for having lateral epicondylitis. A large part with physical findings reported no pain at all in the elbow in any of the two questionnaires, 28% and 22%, respectively. Inter...

  15. Survey on the radiation exposure of the respiratory tract by inhalation of natural radionuclides

    International Nuclear Information System (INIS)

    Poretti, G.

    1987-01-01

    During the last twenty years, work carried out on radiation exposure of the respiratory tract due to the inhaled, naturally occurring nuclides radon, thoron and short-lived daughters has become increasingly important, because the doses received in the respiratory tract, due mainly to the effect of α rays, reach values among the general population which are comparable to or even higher than the average exposures per year of a population undergoing X-ray diagnostic examinations. A brief introduction to the physical characteristics of the natural radiation nuclides reaching the bronchi and lungs with the inhaled air (Rn-220 - thoron and short lived daughters), and the deposition and clearance of the nuclides (often linked to aerosols), is followed by a discussion of the anatomical/physiological characteristics of the ''lung models'', thanks to which it is possible to calculate the energy quantities (i.e. doses) deposited by the α rays in the epithelium of the lungs and bronchi. In addition the retention mechanisms of the radionuclides (as free ions or as aerosols) are briefly described, and finally the calculations to determine the quantity of radioactivity remaining on the walls of the respiratory tract are given. The construction of dosimetric models requires relatively precise knowledge of the thickness of the mucus layers and of the distribution of the nuclides in the mucus, the ciliary movement, the depth in the tissue of the radiation-sensitive cells etc. On the basis of local doses it is then possible to calculate approximately the regional doses for bronchi, lungs and other organs (via blood, accessible by the nuclides before excretion) for the short lived daughters of Rn-222 and Rn-220. Determination of the mean effective dose equivalent requires, amongst other things, knowledge of the concentration of the nuclides in the inhaled air and the mean respiratory frequency of the members of a population. (orig./HSI)

  16. Examining the Values of Students in the Physical Education and Sport Departments

    Science.gov (United States)

    Gullu, Mehmet

    2016-01-01

    In this study, the values of students in the physical education and sport departments were examined according to their gender, age, grade, and departments. The questionnaire method was used in the study. As the data collection tool, the Portrait Values Questionnaire was applied. The study group consisted of a total of 389 students 126 of whom were…

  17. Examining a conceptual model of parental nurturance, parenting practices and physical activity among 5-6 year olds.

    Science.gov (United States)

    Sebire, Simon J; Jago, Russell; Wood, Lesley; Thompson, Janice L; Zahra, Jezmond; Lawlor, Deborah A

    2016-01-01

    Parenting is an often-studied correlate of children's physical activity, however there is little research examining the associations between parenting styles, practices and the physical activity of younger children. This study aimed to investigate whether physical activity-based parenting practices mediate the association between parenting styles and 5-6 year-old children's objectively-assessed physical activity. 770 parents self-reported parenting style (nurturance and control) and physical activity-based parenting practices (logistic and modeling support). Their 5-6 year old child wore an accelerometer for five days to measure moderate-to-vigorous physical activity (MVPA). Linear regression was used to examine direct and indirect (mediation) associations. Data were collected in the United Kingdom in 2012/13 and analyzed in 2014. Parent nurturance was positively associated with provision of modeling (adjusted unstandardized coefficient, β = 0.11; 95% CI = 0.02, 0.21) and logistic support (β = 0.14; 0.07, 0.21). Modeling support was associated with greater child MVPA (β = 2.41; 0.23, 4.60) and a small indirect path from parent nurturance to child's MVPA was identified (β = 0.27; 0.04, 0.70). Physical activity-based parenting practices are more strongly associated with 5-6 year old children's MVPA than parenting styles. Further research examining conceptual models of parenting is needed to understand in more depth the possible antecedents to adaptive parenting practices beyond parenting styles. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  18. Examine the Relationship between Dynamic Balance and Physical Fitness Tests in Preschool Children

    OpenAIRE

    杉浦, 宏季; Sugiura, Hiroki; 杉本, 寛恵; Sugimoto, Hiroe

    2016-01-01

    This study examined the relationship between dynamic balance tests and various physical fitness tests in preschool children. The subjects were 22 preschool children (age, 5.0+0.4years; height, 107.3+5.7cm; weight, 17.9+3.4 kg). Dynamic balance was assessed by walking the length of a balance beam several times (beam height, 30cm; width, 10cm; length, 200cm) and walking a pathway (width, 10cm; length, 200cm). Physical fitness was assessed with activities such as a 25-meter run, continuous bilat...

  19. Improvement of respiratory symptoms following Heller myotomy for achalasia.

    Science.gov (United States)

    Khandelwal, Saurabh; Petersen, Rebecca; Tatum, Roger; Sinan, Huseyin; Aaronson, Daniel; Mier, Fernando; Martin, Ana V; Pellegrini, Carlos A; Oelschlager, Brant K

    2011-02-01

    Although patients with achalasia complain mainly of dysphagia, we have observed that they also have a high rate of respiratory problems. We hypothesized that the latter may be due to poor esophageal clearance leading to aspiration. This study examines the effect of Heller myotomy on these symptoms. We studied the course of 111 patients with achalasia who underwent Heller myotomy between 1994 and 2008 and who agreed to participate in this study. All patients completed a questionnaire postoperatively assessing the preoperative and postoperative prevalence and severity of symptoms using visual analog scales. Patients were divided into two groups: one that included all those with respiratory symptoms (dyspnea, hoarseness, cough, wheezing, sore throat, and/or a history of asthma or pneumonia) prior to myotomy and one that included those without those symptoms. All patients presented with dysphagia as their primary complaint, and 63 (57%) reported respiratory symptoms or disease prior to surgery. There were no significant differences in preoperative characteristics between those with and without respiratory manifestations. After a median follow-up of 71 months (range 9-186 months), 55 (87%) patients reported durable improvement of dysphagia. The frequency and severity of all respiratory symptoms decreased significantly. Twenty-four of the 29 patients (82%) who reported a history of pneumonia prior to surgery did not experience recurrent episodes after Heller myotomy. A Heller myotomy is effective in improving esophageal emptying in patients with achalasia. This results in sustained improvement of dysphagia and associated respiratory symptoms/diseases. This suggests that respiratory symptoms/diseases in these patients are likely caused by esophageal retention of food and secretions, and then aspiration.

  20. Elevated exhaled nitric oxide in anaphylaxis with respiratory symptoms

    Directory of Open Access Journals (Sweden)

    Yoichi Nakamura

    2015-10-01

    Conclusions: Elevation of FeNO was related to respiratory symptoms observed in anaphylactic patients without asthma. Although the mechanism of increased FeNO level is unclear, its usefulness for diagnosis of anaphylaxis must be examined in prospective studies.

  1. Respiratory Virus Detection and Clinical Diagnosis in Children Attending Day Care.

    Directory of Open Access Journals (Sweden)

    Nina Moe

    Full Text Available Respiratory viruses often have been studied in children with respiratory tract infection (RTI, but less knowledge exists about viruses in asymptomatic children. We have studied the occurrence of a broad panel of respiratory viruses in apparently healthy children attending day care, taking into account the influence of possible confounding factors, such as age, clinical signs of respiratory tract infection (RTI, location (day-care section and season.We have studied 161 children in two day-care centers, each with separate sections for younger and older children, during four autumn and winter visits over a two-year period. A total of 355 clinical examinations were performed, and 343 nasopharyngeal samples (NPS were analyzed by semi-quantitative, real-time, polymerase chain reaction (PCR tests for 19 respiratory pathogens.Forty-three percent of all NPS were PCR-positive for ≥ 1 of 13 virus species, with high species variation during visits. Rhinovirus 26% (88/343 NPS, enterovirus 12% (40/343 and parechovirus 9% (30/343 were detected in every visit, and the rates varied in relation to age, day-care section and season. Ten other viruses were detected in ≤ 3% of the NPS. Generally, viruses occurred together in the NPS. In 24% (79/331 of the clinical examinations with available NPS, the children had clear signs of RTI, while in 41% (135/331 they had mild signs, and in 35% (117/331 the children had no signs of RTI. Moreover, viruses were found in 70% (55/79 of children with clear signs of RTI, in 41% (55/135 with mild signs and in 30% (35/117 without any signs of RTI (p < 0.001.Positive PCR tests for respiratory viruses, particularly picornaviruses, were frequently detected in apparently healthy children attending day care. Virus detection rates were related to age, presence of clinical signs of RTI, location in day care and season.

  2. Upper respiratory infections and barotrauma among commercial pilots

    DEFF Research Database (Denmark)

    Boel, Nina Monrad; Klokker, Mads

    2017-01-01

    BACKGROUND: Health incapacitation is a serious threat to flight safety. Therefore, a study conducted 10 yr ago examined the incidents of ear-nose-throat (ENT) barotrauma and upper respiratory infection (URI) among commercial pilots and found that a large number continued to carry out their duties...

  3. Do extra compulsory physical education lessons mean more physically active children - findings from the childhood health, activity, and motor performance school study Denmark (The CHAMPS-study DK)

    DEFF Research Database (Denmark)

    Møller, Niels; Tarp, Jakob; Kamelarczyk, Eva

    2014-01-01

    modifications by status of overweight/obesity and poor cardio-respiratory fitness are examined.MethodsParticipants were from the first part of the CHAMPS-study DK, which included approximately 1200 children attending the 0th ¿ 6th grade. At the sports schools, the mandatory physical education (PE) program...... schools and normal schools, respectively. However, children, especially boys, attending sports schools were more active during school time than children attending normal schools (girls: ß=51, p=0.065; boys: ß=113, p

  4. Who Becomes a Physics Major? A Long-term Longitudinal Study Examining the Roles of Pre-college Beliefs about Physics and Learning Physics, Interest, and Academic Achievement

    Science.gov (United States)

    Perkins, Katherine K.; Gratny, Mindy

    2010-10-01

    In this paper, we examine the correlation between students' beliefs upon entering college and their likelihood of continuing on to become a physics major. Since 2004, we have collected CLASS survey and self-reported level-of-interest responses from students in the first-term, introductory calculus-based physics course (N>2500). Here, we conduct a retrospective analysis of students' incoming CLASS scores and level of interest, comparing those students who go on to become physics majors with those who do not. We find the incoming CLASS scores and reported interest of these future physics majors to be substantially higher than the class average, indicating that these students enter their first college course already having quite expert-like beliefs. The comparative differences are much smaller for grades, SAT score, and university predicted-GPA.

  5. Managing respiratory problems in athletes.

    Science.gov (United States)

    Hull, James H; Ansley, Les; Robson-Ansley, Paula; Parsons, Jonathan P

    2012-08-01

    Respiratory problems are common in athletes of all abilities and can significantly impact upon their health and performance. In this article, we provide an overview of respiratory physiology in athletes. We also discuss the assessment and management of common clinical respiratory conditions as they pertain to athletes, including airways disease, respiratory tract infection and pneumothorax. We focus on providing a pragmatic approach and highlight important caveats for the physician treating respiratory conditions in this highly specific population.

  6. Extracting a respiratory signal from raw dynamic PET data that contain tracer kinetics

    International Nuclear Information System (INIS)

    Schleyer, P J; Thielemans, K; Marsden, P K

    2014-01-01

    Data driven gating (DDG) methods provide an alternative to hardware based respiratory gating for PET imaging. Several existing DDG approaches obtain a respiratory signal by observing the change in PET-counts within specific regions of acquired PET data. Currently, these methods do not allow for tracer kinetics which can interfere with the respiratory signal and introduce error. In this work, we produced a DDG method for dynamic PET studies that exhibit tracer kinetics. Our method is based on an existing approach that uses frequency-domain analysis to locate regions within raw PET data that are subject to respiratory motion. In the new approach, an optimised non-stationary short-time Fourier transform was used to create a time-varying 4D map of motion affected regions. Additional processing was required to ensure that the relationship between the sign of the respiratory signal and the physical direction of movement remained consistent for each temporal segment of the 4D map. The change in PET-counts within the 4D map during the PET acquisition was then used to generate a respiratory curve. Using 26 min dynamic cardiac NH 3 PET acquisitions which included a hardware derived respiratory measurement, we show that tracer kinetics can severely degrade the respiratory signal generated by the original DDG method. In some cases, the transition of tracer from the liver to the lungs caused the respiratory signal to invert. The new approach successfully compensated for tracer kinetics and improved the correlation between the data-driven and hardware based signals. On average, good correlation was maintained throughout the PET acquisitions. (paper)

  7. Respiratory Syncytial Virus

    Science.gov (United States)

    ... with facebook share with twitter share with linkedin Respiratory Syncytial Virus (RSV) Credit: CDC This is the ... the United States. Why Is the Study of Respiratory Syncytial Virus (RSV) a Priority for NIAID? In ...

  8. Medial tibial stress syndrome can be diagnosed reliably using history and physical examination

    NARCIS (Netherlands)

    Winters, M.; Bakker, E. W. P.; Moen, M. H.; Barten, C. C.; Teeuwen, R.; Weir, A.

    2017-01-01

    The majority of sporting injuries are clinically diagnosed using history and physical examination as the cornerstone. There are no studies supporting the reliability of making a clinical diagnosis of medial tibial stress syndrome (MTSS). Our aim was to assess if MTSS can be diagnosed reliably, using

  9. Influenza and other respiratory virus infections in outpatients with medically attended acute respiratory infection during the 2011-12 influenza season.

    Science.gov (United States)

    Zimmerman, Richard K; Rinaldo, Charles R; Nowalk, Mary Patricia; Gk, Balasubramani; Thompson, Mark G; Moehling, Krissy K; Bullotta, Arlene; Wisniewski, Stephen

    2014-07-01

    Respiratory tract infections are a major cause of outpatient visits, yet only a portion is tested to determine the etiologic organism. Multiplex reverse transcriptase polymerase chain reaction (MRT-PCR) assays for detection of multiple viruses are being used increasingly in clinical settings. During January-April 2012, outpatients with acute respiratory illness (≤ 7 days) were tested for influenza using singleplex RT-PCR (SRT-PCR). A subset was assayed for 18 viruses using MRT-PCR to compare detection of influenza and examine the distribution of viruses and characteristics of patients using multinomial logistic regression. Among 662 participants (6 months-82 years), detection of influenza was similar between the MRT-PCR and SRT-PCR (κ = 0.83). No virus was identified in 267 (40.3%) samples. Commonly detected viruses were human rhinovirus (HRV, 15.4%), coronavirus (CoV, 10.4%), respiratory syncytial virus (RSV, 8.4%), human metapneumovirus (hMPV, 8.3%), and influenza (6%). Co-detections were infrequent (6.9%) and most commonly occurred among those infections (P = 0.008), nasal congestion was more frequent in CoV, HRV, hMPV, influenza and RSV infections (P = 0.001), and body mass index was higher among those with influenza (P = 0.036). Using MRT-PCR, a viral etiology was found in three-fifths of patients with medically attended outpatient visits for acute respiratory illness during the influenza season; co-detected viruses were infrequent. Symptoms varied by viral etiology. © 2014 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.

  10. Associations between lifetime potentially traumatic events and chronic physical conditions in the South African Stress and Health Survey: a cross-sectional study.

    Science.gov (United States)

    Atwoli, Lukoye; Platt, Jonathan M; Basu, Archana; Williams, David R; Stein, Dan J; Koenen, Karestan C

    2016-07-07

    This study examined the association between the type, and cumulative number of lifetime potentially traumatic events (PTEs), and chronic physical conditions, in a South African sample. PTE exposures have been associated with an increased risk for a wide range of chronic physical conditions, but it is unclear whether psychiatric disorders mediate this association. Given the established differences in trauma occurrence, and the epidemiology of posttraumatic stress disorder (PTSD) in South Africa relative to other countries, examining associations between PTEs and chronic physical conditions, particularly while accounting for psychiatric comorbidity is important. Data were drawn from the South African Stress and Health Study, a cross-sectional population-representative study of psychological and physical health of South African adults. Twenty-seven PTEs, based on the World Health Organization Composite International Diagnostic Interview Version 3.0, DSM-IV PTSD module were grouped into seven PTE types (war events, physical violence, sexual violence, accidents, unexpected death of a loved one, network events, and witnessing PTEs). Five clusters of physical conditions (cardiovascular, arthritis, respiratory, chronic pain, and other health conditions) were examined. Logistic regressions assessed the odds of reporting a physical condition in relation to type and cumulative number of PTEs. Cochran-Armitage test for trend was used to examine dose-response effect of cumulative PTEs on physical conditions. After adjusting for sociodemographic variables and psychiatric disorders, respondents with any PTE had increased odds of all assessed physical conditions, ranging between 1.48 (95 % CI: 1.06-2.07) for arthritis and 2.07 (95 % CI: 1.57-2.73) for respiratory conditions, compared to those without PTE exposure. Sexual violence, physical violence, unexpected death of a loved one, and network PTEs significantly increased the odds of all or nearly all the physical conditions

  11. The influence of students' gender on equity in Peer Physical Examination: a qualitative study.

    Science.gov (United States)

    Vnuk, Anna K; Wearn, Andy; Rees, Charlotte E

    2017-08-01

    Peer Physical Examination (PPE) is an educational tool used globally for learning early clinical skills and anatomy. In quantitative research, there are differences in students' preferences and actual participation in PPE by gender. This novel study qualitatively explores the effect that gender has on medical students' experiences of learning physical examination through PPE. We employ an interpretative approach to uncover the PPE experiences of students from a European, graduate-entry medical school. Volunteers participated in either individual or group interviews. The data were transcribed, de-identified and analysed using thematic analysis. There was evidence of gender inequity in PPE, with students describing significant imbalances in participation. Male students adopted roles that generated significant personal discomfort and led to fewer experiences as examiners. Assumptions were made by tutors and students about gender roles: male students' ready acceptance of exposure to be examined and female students' need to be protected from particular examinations. In contrast with the first assumption, male students did feel coerced or obliged to be examined. Students described their experiences of taking action to break down the gender barrier. Importantly, students reported that tutors played a role in perpetuating inequities. These findings, whilst relating to one university, have implications for all settings where PPE is used. Educators should be vigilant about gender issues and the effect that they may have on students' participation in PPE to ensure that students are not disadvantaged in their learning.

  12. 10 CFR 850.28 - Respiratory protection.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Respiratory protection. 850.28 Section 850.28 Energy... Respiratory protection. (a) The responsible employer must establish a respiratory protection program that complies with the respiratory protection program requirements of 29 CFR 1910.134, Respiratory Protection...

  13. Respiratory viral infections in infancy and school age respiratory outcomes and healthcare costs.

    Science.gov (United States)

    MacBean, Victoria; Drysdale, Simon B; Yarzi, Muska N; Peacock, Janet L; Rafferty, Gerrard F; Greenough, Anne

    2018-03-01

    To determine the impact of viral lower respiratory tract infections (LRTIs) in infancy including rhinovirus (RV) and infancy respiratory syncytial virus (RSV), on school age pulmonary function and healthcare utilization in prematurely born children. School age respiratory outcomes would be worse and healthcare utilization greater in children who had viral LRTIs in infancy. Prospective study. A cohort of prematurely born children who had symptomatic LRTIs during infancy documented, was recalled. Pulmonary function was assessed at 5 to 7 years of age and health related costs of care from aged one to follow-up determined. Fifty-one children, median gestational age 33 +6 weeks, were assessed at a median (IQR) age 7.03 (6.37-7.26) years. Twenty-one children had no LRTI, 14 RV LRTI, 10 RSV LRTI, and 6 another viral LRTI (other LRTI). Compared to the no LRTI group, the RV group had a lower FEV 1 (P = 0.033) and the other LRTI group a lower FVC (P = 0.006). Non-respiratory medication costs were higher in the RV (P = 0.018) and RSV (P = 0.013) groups. Overall respiratory healthcare costs in the RV (£153/year) and RSV (£27/year) groups did not differ significantly from the no LRTI group (£56/year); the other LRTI group (£431/year) had higher respiratory healthcare costs (P = 0.042). In moderately prematurely born children, RV and RSV LRTIs in infancy were not associated with higher respiratory healthcare costs after infancy. Children who experienced LRTIs caused by other respiratory viruses (including RV) had higher respiratory healthcare costs and greater pulmonary function impairment. © 2018 Wiley Periodicals, Inc.

  14. Respiratory viruses in children hospitalized for acute lower respiratory tract infection in Ghana.

    Science.gov (United States)

    Kwofie, Theophilus B; Anane, Yaw A; Nkrumah, Bernard; Annan, Augustina; Nguah, Samuel B; Owusu, Michael

    2012-04-10

    Acute respiratory tract infections are one of the major causes of morbidity and mortality among young children in developing countries. Information on the viral aetiology of acute respiratory infections in developing countries is very limited. The study was done to identify viruses associated with acute lower respiratory tract infection among children less than 5 years. Nasopharyngeal samples and blood cultures were collected from children less than 5 years who have been hospitalized for acute lower respiratory tract infection. Viruses and bacteria were identified using Reverse Transcriptase Real-Time Polymerase Chain Reaction and conventional biochemical techniques. Out of 128 patients recruited, 33(25.88%%, 95%CI: 18.5% to 34.2%) were positive for one or more viruses. Respiratory Syncytial Virus (RSV) was detected in 18(14.1%, 95%CI: 8.5% to 21.3%) patients followed by Adenoviruses (AdV) in 13(10.2%, 95%CI: 5.5% to 16.7%), Parainfluenza (PIV type: 1, 2, 3) in 4(3.1%, 95%CI: 0.9% to 7.8%) and influenza B viruses in 1(0.8%, 95%CI: 0.0 to 4.3). Concomitant viral and bacterial co-infection occurred in two patients. There were no detectable significant differences in the clinical signs, symptoms and severity for the various pathogens isolated. A total of 61.1% (22/36) of positive viruses were detected during the rainy season and Respiratory Syncytial Virus was the most predominant. The study has demonstrated an important burden of respiratory viruses as major causes of childhood acute respiratory infection in a tertiary health institution in Ghana. The data addresses a need for more studies on viral associated respiratory tract infection.

  15. Analysis of Science Process Skills in West African Senior Secondary School Certificate Physics Practical Examinations in Nigeria

    Directory of Open Access Journals (Sweden)

    A.O. Akinbobola

    2010-06-01

    Full Text Available This study analyzes the science process skills in West African senior secondary school certificate physics practical examinations in Nigeria for a period of 10 years (1998-2007. Ex-post facto design was adopted for the study. The 5 prominent science process skills identified out of the 15 used in the study are: manipulating (17%, calculating (14%, recording (14%, observing (12% and communicating (11%. The results also show high percentage rate of basic (lower order science process skills (63% as compared to the integrated (higher order science process skills (37%. The results also indicate that the number of basic process skills is significantly higher than the integrated process skills in the West African senior secondary school certificate physics practical examinations in Nigeria. It is recommended that the examination bodies in Nigeria should include more integrated science process skills into the senior secondary school physics practical examinations so as to enable the students to be prone to creativity, problem solving, reflective thinking, originality and invention which are vital ingredients for science and technological development of any nation.

  16. Accuracy of pulmonary auscultation to detect abnormal respiratory mechanics: a cross-sectional diagnostic study.

    Science.gov (United States)

    Xavier, Glaciele Nascimento; Duarte, Antonio Carlos Magalhães; Melo-Silva, César Augusto; dos Santos, Carlos Eduardo Ventura Gaio; Amado, Veronica Moreira

    2014-12-01

    Pulmonary auscultation is a method used in clinical practice for the evaluation and detection of abnormalities relating to the respiratory system. This method has limitations, as it depends on the experience and hearing acuity of the examiner to determine adventitious sounds. In this context, it's important to analyze whether there is a correlation between auscultation of lung sounds and the behavior of the respiratory mechanical properties of the respiratory system in patients with immediate postoperative cardiac surgery. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. Reliability and prevalence of physical performance examination assessing mobility and balance in older persons in the US: data from the Third National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Ostchega, Y; Harris, T B; Hirsch, R; Parsons, V L; Kington, R; Katzoff, M

    2000-09-01

    This report provides reliability and prevalence estimates by sex, age, and race/ethnicity of an observed physical performance examination (PPE) assessing mobility and balance. The Third National Health and Nutrition Examination Survey (NHANES III) 1988-1994. A cross-sectional nationally representative survey. All persons aged 60 and older (n = 5,403) who performed the PPE either in the mobile examination center (MEC) or in the home during NHANES III (conducted 1988-1994). The PPE included timed chair stand, full tandem stand, and timed 8-foot walk. Timed chair stand and 8-foot timed walk were reliable measurements (Intraclass Correlations > 0.5). Women were significantly slower (P physically limited than men.

  18. Examining the Knowledge and Capacity of Elementary Teachers to Implement Classroom Physical Activity Breaks

    Directory of Open Access Journals (Sweden)

    Danae M. DINKEL

    2016-09-01

    Full Text Available This study examined teachers’ zone of proximal development for classroom physical activity breaks by assessing teachers’ knowledge and capacity for implementing classroom physical activity breaks. Five school districts of various sizes (n=346 teachers took part in a short online survey. Descriptive statistics were calculated and chi-square analyses were used to identify differences between districts. Almost all teachers utilized classroom physical activity to some extent. A third of teachers who stated they implemented classroom physical activity, experienced barriers to implementation. A majority of teachers were interested in learning more about classroom physical activity. There were significant differences between districts on the number of days per week classroom physical activity was integrated, the frequency of collaboration that occurred between teachers, the percentage of teachers who experienced barriers, and preferred delivery method of professional development. These findings support the importance of identifying teachers’ zone of proximal development to increase the use of classroom physical activity breaks. Understanding teachers’ knowledge and capacity for implementing classroom physical activity breaks can allow educational professionals to shift the implementation of classroom physical activity beyond sporadic use by isolated teachers and schools to a more systematic and consistent delivery across classrooms and throughout districts.

  19. How well do second-year students learn physical diagnosis? Observational study of an objective structured clinical examination (OSCE

    Directory of Open Access Journals (Sweden)

    Simon Steven R

    2002-01-01

    Full Text Available Abstract Background Little is known about using the Objective Structured Clinical Examination (OSCE in physical diagnosis courses. The purpose of this study was to describe student performance on an OSCE in a physical diagnosis course. Methods Cross-sectional study at Harvard Medical School, 1997–1999, for 489 second-year students. Results Average total OSCE score was 57% (range 39–75%. Among clinical skills, students scored highest on patient interaction (72%, followed by examination technique (65%, abnormality identification (62%, history-taking (60%, patient presentation (60%, physical examination knowledge (47%, and differential diagnosis (40% (p Conclusions Students scored higher on interpersonal and technical skills than on interpretive or integrative skills. Station scores identified specific content that needs improved teaching.

  20. Investigation of respiratory disorders in Thoroughbred racehorses training at the Brazilian Jockey Club

    Directory of Open Access Journals (Sweden)

    Natália Rebouças Pires

    Full Text Available ABSTRACT: Athletic horses need to maintain healthy airways for optimal performance. This study investigated the presence of respiratory problems in apparently healthy Thoroughbred racehorses in training. According to the Revised Consensus Statement on Inflammatory Airway Diseases of Horses (2016, determining the prevalence of respiratory disorders in different equine populations is fundamental for understanding these diseases. In total, 72 clinically sound Thoroughbred racehorses, in training at the Brazilian Jockey Club (JCB, were initially examined using interpleural pressure measurement by ventigraphy and respiratory endoscopy. When secretions were present in the airways, transendoscopic tracheal aspiration was performed, and the sample was sent for cytology. The main findings included a combination of bronchospasm and tracheal secretions with 61% of the cytology slides showing neutrophil counts ≥20%. Overall, a significant number of the horses displayed signs suggestive of inflammatory airway disease (mild equine asthma, including 47% with increased DPplmax, 11% with tracheal mucus accumulation [mucus score (MS ≥2] and 18% with carina edema. This was more pronounced in 2-year-old horses within the population studied. These findings are consistent with the literature and reinforce the importance of routine respiratory examination of athletic horses. There is a high incidence of subclinical respiratory disorders in Thoroughbred racehorses in training at the JCB and a significant association between tracheal MS≥2, carina edema, and elevated DPplmax.

  1. An Examination of Sixth Graders' Self-Determined Motivation and Learning in Physical Education

    Science.gov (United States)

    Sun, Haichun; Chen, Ang

    2010-01-01

    Self-determination theory (SDT), when applied in education, emphasizes helping learners internalize extrinsic motivation so as to regulate their learning behavior from an amotivation state to intrinsic motivation. The purpose of this study was to examine the relationship between SDT components and learning in middle school physical education.…

  2. Respiratory hospitalizations of children and residential exposure to traffic air pollution in Jerusalem.

    Science.gov (United States)

    Nirel, Ronit; Schiff, Michal; Paltiel, Ora

    2015-01-01

    Although exposure to traffic-related air pollution has been reported to be associated with respiratory morbidity in children, this association has not been examined in Israel. Jerusalem is ranked among the leading Israeli cities in transport-related air pollution. This case-control study examined whether pediatric hospitalization for respiratory diseases in Jerusalem is related to residential exposure to traffic-related air pollution. Cases (n=4844) were Jerusalem residents aged 0-14 years hospitalized for respiratory illnesses between 2000 and 2006. These were compared to children admitted electively (n=2161) or urgently (n=3085) for non-respiratory conditions. Individual measures of exposure included distance from residence to nearest main road, the total length of main roads, traffic volume, and bus load within buffers of 50, 150, and 300m around each address. Cases were more likely to have any diesel buses passing within 50m of their home (adjusted odds ratios=1.16 and 1.10, 95% confidence intervals 1.04-1.30 and 1.01-1.20 for elective and emergency controls, respectively). Our findings indicated that older girls (5-14) and younger boys (0-4) had increased risks of respiratory hospitalization, albeit with generally widened confidence intervals due to small sample sizes. Our results add to the limited body of evidence regarding associations between diesel exhaust particles and respiratory morbidity. The findings also point to possible differential associations between traffic-related air pollution and pediatric hospitalization among boys and girls in different age groups. Copyright © 2014 Elsevier GmbH. All rights reserved.

  3. Utility of AD8 for Cognitive Impairment in a Chinese Physical Examination Population: A Preliminary Study

    Science.gov (United States)

    Xie, Yue; Gao, Ya; Jia, Jianjun; Wang, Xiaohong; Wang, Zhenfu; Xie, Hengge

    2014-01-01

    Objective. To investigate the utility of AD8 for cognitive impairment in a Chinese physical examination population. Methods. Military cadres who took routine physical examination in Chinese PLA General Hospital from Jan 1, 2013, to Dec 31, 2013, were subjected to AD8 scale. Individual information such as age, gender, and education was also collected. All data were analyzed by SPSS 19.0. Results. 1544 subjects were enrolled in this study with mean age 75.4 ± 10.6 years. The subjects who scored 0 to 8 of AD8 scale were 1015, 269, 120, 60, 30, 14, 19, 8, and 9, respectively. Corresponding proportions were 65.7%, 17.4%, 7.8%, 3.9%, 2.0%, 0.9%, 1.2%, 0.5%, and 0.6%, respectively. The endorsement prevalence of 8 questions was 5.6%, 9.2%, 6.6%, 9.2%, 4.8%, 4.5%, 8.9%, and 24.1%, respectively. The endorsement prevalence of question 8 was significantly higher than others (P physical examination population. PMID:25436227

  4. How close are we to definitively identifying the respiratory health effects of e-cigarettes?

    Science.gov (United States)

    Ratajczak, Alexsandra; Feleszko, Wojciech; Smith, Danielle M; Goniewicz, Maciej

    2018-07-01

    Use of electronic cigarettes (e-cigarettes) is frequently promoted as a less harmful alternative to cigarette smoking. The impact of repeated inhalation of e-cigarette aerosols on respiratory health is not well understood. Areas covered: Using results from laboratory, observational, and clinical studies, we synthesize evidence relevant to potential respiratory health effects that may result from inhalation of e-cigarette aerosols. Expert commentary: Chemical analyses reveal that e-cigarette aerosols contain numerous respiratory irritants and toxicants. There are documented cytotoxic effects of e-cigarette constituents on lung tissue. Studies among ex-smokers who switched to e-cigarettes note reduced exposure to numerous respiratory toxicants, reduced asthma exacerbations, and chronic obstructive pulmonary disease symptoms. Regular exposure to e-cigarette aerosols is associated with impaired respiratory functioning. Potential respiratory health risks resulting from secondhand e-cigarette aerosol exposure have not been sufficiently evaluated. Current evidence indicates that although e-cigarettes are not without risk, these products seemingly pose fewer respiratory health harms issues compared to tobacco cigarettes. Data from prospective studies and randomized controlled trials examining the impact of e-cigarette use on lung health are needed to better understand respiratory health risks tied to use of these products.

  5. An examination of multilevel factors that may explain gender differences in children's physical activity.

    Science.gov (United States)

    Crespo, Noe C; Corder, Kirsten; Marshall, Simon; Norman, Gregory J; Patrick, Kevin; Sallis, Jim F; Elder, John P

    2013-09-01

    Girls are less physically active than boys, yet no single study has examined the factors that may explain gender differences in children's physical activity (PA). This study was a cross-sectional analysis of data from 116 caregivers and their children aged 5-8 years who participated in the MOVE study. Caregivers reported various factors that may relate to children's PA (eg, encouragement for child PA and PA equipment at home). Child PA was measured by 7-day accelerometry. Linear regression tested for the variance in moderate-to-vigorous physical activity (MVPA) explained by gender and several variables. Gender and ethnicity interactions were examined. Caregivers were mostly female (97%), mean age 38 ± 6 years, mean BMI 28 ± 6 (kg/m2). Child's mean age was 8.1 ± 0.7, 54% were female and 40% were overweight/obese. Girls were less physically active than boys (54.1 ± 19.7 vs. 65.2 ± 28.0 daily minutes of MVPA, respectively). Among girls, more days of PE/week was associated with greater MVPA. Among boys, greater parent support for PA, greater parent modeling for PA, and greater number of PA equipment in the home were associated with greater MVPA. This study supports that boys and girls have different correlates for MVPA, which may partly explain gender differences in PA.

  6. Respiratory manifestations in 38 patients with Alström syndrome.

    Science.gov (United States)

    Boerwinkle, Caroline; Marshall, Jan D; Bryant, Joy; Gahl, William A; Olivier, Kenneth N; Gunay-Aygun, Meral

    2017-04-01

    Alström syndrome (AS) is a rare, multi-system condition characterized by retinal degeneration, sensorineural hearing loss, obesity, insulin-resistant diabetes, hypertriglyceridemia, cardiomyopathy, hepatorenal disease, and recurrent respiratory infections. It belongs to a group of genetic disorders known as primary ciliopathies, which includes autosomal dominant and recessive polycystic kidney diseases, as well as Joubert and Bardet-Biedl syndromes. Prior studies have suggested phenotypic overlap between primary ciliopathies affecting the non-motile, sensory cilia, and primary ciliary dyskinesia (PCD), a motile ciliopathy characterized by respiratory tract disease. We describe the burden of oto-sino-pulmonary disease in 38 individuals with AS and examines the degree of clinical overlap between PCD and AS. Evaluation at the NIH Clinical Center included clinical examination, chest imaging, and clinical history surveys, as well as measurement of nasal nitric oxide (nNO) in nine patients. Recurrent otitis media was ubiquitous in the AS cohort (92%) with 50% requiring pressure equalization tube placement. A history of bronchitis/pneumonia and sinusitis was reported in 61% and 50% of individuals, respectively. PCD-characterizing symptoms (laterality defects, unexplained neonatal respiratory distress, year-round nasal congestion, and wet cough) were far less prevalent in the AS cohort compared to PCD, and the average nNO production in the AS cohort was 232 ± 57.1 nl/min compared to a cut-off of <77 nl/min for PCD. These data suggest that the oto-sino-respiratory complications in AS are prominent enough to warrant increased clinical attention, but significantly impaired respiratory cilia function as seen in PCD is unlikely in AS. (www.clinicaltrials.gov, trial NCT00068224) Pediatr Pulmonol. 2017;52:487-493. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  7. [Respiratory symptoms and atmospheric pollution and respiratory symptoms in the general population].

    Science.gov (United States)

    Simon, I; Charpin, D

    2010-06-01

    Epidemiological studies on air pollution have mainly been interested in the effects of short- or long-term exposure on patients suffering from respiratory illnesses. Fewer studies have addressed the acute effects of air pollution on respiratory symptoms in the general population. We conducted a review of the literature over the last 16years that has addressed the impact of atmospheric pollution on respiratory symptoms in the general population to estimate the magnitude of effect. The majority of studies demonstrated a significant association between exposure to air pollutants and the occurrence of respiratory symptoms, without any threshold. Although a link between atmospheric pollution and respiratory symptoms has been demonstrated, knowledge of the effects of specific air pollutants and the effect of pollution on particular vulnerable groups (infants, young children, the elderly) is still limited. There is a need for further studies in this area. Copyright 2010 SPLF. Published by Elsevier Masson SAS. All rights reserved.

  8. Incremental Value of Pocket-Sized Echocardiography in Addition to Physical Examination during Inpatient Cardiology Evaluation: A Multicenter Italian Study (SIEC).

    Science.gov (United States)

    Di Bello, Vitantonio; La Carrubba, Salvatore; Conte, Lorenzo; Fabiani, Iacopo; Posteraro, Alfredo; Antonini-Canterin, Francesco; Barletta, Valentina; Nicastro, Irene; Mariotti, Egidio; Severino, Sergio; Caso, Pio; Benedetto, Frank; Savino, Ketty; Carerj, Scipione

    2015-10-01

    We prospectively assessed the incremental value of a pocket-sized echocardiography (PSE) device during cardiology consultations, in addition to physical examination, ECG reading, and chest x-ray. A total of 443 consecutive patients (53% men), referred for bedside consultations, underwent physical examination, ECG, and CXR, followed by PSE examination. The physician completed a detailed questionnaire (clinical and echocardiographic data, scanning time, abnormal results). Receiver operating characteristic (ROC) curve analysis was generated to test the predictive discrimination value of the different methods. The incremental value of PSE examination compared to clinical visit alone or combined with ECG results was expressed as a global chi-square value. The PSE examination did not influence the definitive diagnosis in only 23.5% of cases, while 25.3% of the diagnoses were confirmed and verified by PSE. The clinical diagnosis was enriched by PSE in 21.9% of cases, and the diagnosis was changed in 26.2%. The area under curve (AUC) of physical examination + ECG results (sensitivity: 80%; specificity: 67%) was significantly higher than physical examination alone (sensitivity: 75%; specificity: 62%) (P echocardiography. © 2015, Wiley Periodicals, Inc.

  9. Using cluster analysis to examine the combinations of motivation regulations of physical education students.

    Science.gov (United States)

    Ullrich-French, Sarah; Cox, Anne

    2009-06-01

    According to self-determination theory, motivation is multidimensional, with motivation regulations lying along a continuum of self-determination (Ryan & Deci, 2007). Accounting for the different types of motivation in physical activity research presents a challenge. This study used cluster analysis to identify motivation regulation profiles and examined their utility by testing profile differences in relative levels of self-determination (i.e., self-determination index), and theoretical antecedents (i.e., competence, autonomy, relatedness) and consequences (i.e., enjoyment, worry, effort, value, physical activity) of physical education motivation. Students (N= 386) in 6th- through 8th-grade physical education classes completed questionnaires of the variables listed above. Five profiles emerged, including average (n = 81), motivated (n = 82), self-determined (n = 91), low motivation (n = 73), and external (n = 59). Group difference analyses showed that students with greater levels of self-determined forms of motivation, regardless of non-self-determined motivation levels, reported the most adaptive physical education experiences.

  10. Do current sports brassiere designs impede respiratory function?

    Science.gov (United States)

    Bowles, Kelly-Ann; Steele, Julie R; Chaunchaiyakul, Rungchai

    2005-09-01

    Although sports brassieres are more effective in limiting breast motion and related breast pain when compared with standard fashion brassieres, some females do not wear sports brassieres during physical activity, as they perceive them to be too tight around the torso, possibly impeding their performance during physical activity. The purpose of this study was to determine whether breast hypertrophy, breast momentum, and/or wearing a sports brassiere impeded respiratory function at rest and during physical activity. Twenty-two active women completed standard resting spirometry maneuvers while not wearing a brassiere. All subjects then completed maximal cycle ergometer testing in two breast support conditions (sports brassiere and no brassiere (NB)), followed by submaximal treadmill exercise tests under three breast support conditions (sports brassiere, no brassiere and fashion brassiere) while standard spirometry, brassiere pressure and comfort were measured. The sports brassiere imparted significantly more pressure on smaller breasted females' torsos when compared with the fashion brassiere (0.861 +/- 0.247 and 0.672 +/- 0.254 N.cm(-2), respectively), although this increased pressure did not appear to significantly affect measured lung volumes or brassiere comfort scores. Brassiere size affected maximal exercise ability (relative VO(2peak): smaller breasted NB: 49.84 +/- 6.15 mL.kg(-1).min(-1); larger breasted NB: 40.76 +/- 4.47 mL.kg(-1).min(-1)) as well as some temporal measures of resting and submaximal respiration. However, no significant difference was found between the no brassiere and brassiere conditions in regards to measured lung volumes. As no significant restriction to exercise performance or respiratory mechanics was found when subjects wore sports brassieres, it was concluded that active females should wear a sports brassiere during physical activity to reduce breast motion and related breast pain.

  11. [A case of Crow-Fukase syndrome with respiratory failure due to bilateral diaphragmatic paralysis].

    Science.gov (United States)

    Namekawa, Michito; Muramatsu, Shin-ichi; Hashimoto, Ritsuo; Kawakami, Tadataka; Fujimoto, Ken-ichi; Nakano, Imaharu

    2002-07-01

    A 62-year-old man with well-controlled diabetes mellitus developed numbness of the bilateral feet and hands, followed by subacutely progressive weakness and amyotrophy of extremities. He became bed-ridden state, and dyspnea also appeared, so he was referred to our hospital. Physical examination revealed a lean man, with dark-reddish skin pigmentation, crabbed fingers, bilateral pretibial pitting edema, and bristles in extremities. Thoracoabdominal paradoxical respiration was observed and pulmonary vesicular sounds was decreased markedly in the both lungs. Laboratory data revealed hypoproteinemia, abnormalities of endocrine system, but M-protein was not detected. Serum vascular endothelial growth factor level was quite high. Chest radiography revealed elevation of the bilateral diaphragm, the % vital capacity (%VC) was 24%, and arterial blood gas analysis showed marked hypoxia with hypercapnia. These findings suggested that his respiratory failure was induced by bilateral diaphragmatic paralysis caused by bilateral phrenic nerve palsy due to Crow-Fukase syndrome. He became somnolent because of hypercapnic narcosis, so non-invasive positive pressure ventilation (NIPPV) was started. We treated him with intravenous immunoglobulin and oral corticosteroids therapies, and after these therapies, his symptoms were remarkably recovered and NIPPV became unnecessary soon. The most frequent causes of respiratory failure in Crow-Fukase syndrome are pleural effusion and pulmonary hypertension, and only two cases of this syndrome with respiratory failure caused by bilateral diaphragmatic paralysis were reported until now. When the patients with Crow-Fukase syndrome complain of dyspnea, we should take the diaphragmatic paralysis into consideration, which may be improved by appropriate therapies.

  12. Respiratory viruses in children hospitalized for acute lower respiratory tract infection in Ghana

    Directory of Open Access Journals (Sweden)

    Kwofie Theophilus B

    2012-04-01

    Full Text Available Abstract Background Acute respiratory tract infections are one of the major causes of morbidity and mortality among young children in developing countries. Information on the viral aetiology of acute respiratory infections in developing countries is very limited. The study was done to identify viruses associated with acute lower respiratory tract infection among children less than 5 years. Method Nasopharyngeal samples and blood cultures were collected from children less than 5 years who have been hospitalized for acute lower respiratory tract infection. Viruses and bacteria were identified using Reverse Transcriptase Real-Time Polymerase Chain Reaction and conventional biochemical techniques. Results Out of 128 patients recruited, 33(25.88%%, 95%CI: 18.5% to 34.2% were positive for one or more viruses. Respiratory Syncytial Virus (RSV was detected in 18(14.1%, 95%CI: 8.5% to 21.3% patients followed by Adenoviruses (AdV in 13(10.2%, 95%CI: 5.5% to 16.7%, Parainfluenza (PIV type: 1, 2, 3 in 4(3.1%, 95%CI: 0.9% to 7.8% and influenza B viruses in 1(0.8%, 95%CI: 0.0 to 4.3. Concomitant viral and bacterial co-infection occurred in two patients. There were no detectable significant differences in the clinical signs, symptoms and severity for the various pathogens isolated. A total of 61.1% (22/36 of positive viruses were detected during the rainy season and Respiratory Syncytial Virus was the most predominant. Conclusion The study has demonstrated an important burden of respiratory viruses as major causes of childhood acute respiratory infection in a tertiary health institution in Ghana. The data addresses a need for more studies on viral associated respiratory tract infection.

  13. Examining the Physical Self in Adolescent Girls Over Time: Further Evidence against the Hierarchical Model.

    Science.gov (United States)

    Kowalski, Kent C.; Crocker, Peter R. E.; Kowalski, Nanette P.; Chad, Karen E.; Humbert, M. Louise

    2003-01-01

    Examined the direction of causal flow between global and specific dimensions of self-concept. Adolescent girls completed the Physical Self-Perception Profile and a global self-esteem scale in 9th and 10th grade. Results showed little support for top-down or bottom-up effects over the year. When self-concept was examined over time, there was…

  14. Anti-Aspergillus Activities of the Respiratory Epithelium in Health and Disease

    Directory of Open Access Journals (Sweden)

    Margherita Bertuzzi

    2018-01-01

    Full Text Available Respiratory epithelia fulfil multiple roles beyond that of gaseous exchange, also acting as primary custodians of lung sterility and inflammatory homeostasis. Inhaled fungal spores pose a continual antigenic, and potentially pathogenic, challenge to lung integrity against which the human respiratory mucosa has developed various tolerance and defence strategies. However, respiratory disease and immune dysfunction frequently render the human lung susceptible to fungal diseases, the most common of which are the aspergilloses, a group of syndromes caused by inhaled spores of Aspergillus fumigatus. Inhaled Aspergillus spores enter into a multiplicity of interactions with respiratory epithelia, the mechanistic bases of which are only just becoming recognized as important drivers of disease, as well as possible therapeutic targets. In this mini-review we examine current understanding of Aspergillus-epithelial interactions and, based upon the very latest developments in the field, we explore two apparently opposing schools of thought which view epithelial uptake of Aspergillus spores as either a curative or disease-exacerbating event.

  15. Comparative Analyses of Physics Candidates Scores in West African and National Examinations Councils

    Science.gov (United States)

    Utibe, Uduak James; Agah, John Joseph

    2015-01-01

    The study is a comparative analysis of physics candidates' scores in West African and National Examinations Councils. It also investigates influence of gender. Results of 480 candidates were randomly selected form three randomly selected Senior Science Colleges using the WASSCE and NECOSSCE computer printout sent to the schools, transformed using…

  16. Data on respiratory variables in critically ill patients with acute respiratory failure placed on proportional assist ventilation with load adjustable gain factors (PAV+

    Directory of Open Access Journals (Sweden)

    Dimitris Georgopoulos

    2016-09-01

    Full Text Available The data show respiratory variables in 108 critically ill patients with acute respiratory failure placed on proportional assist ventilation with load adjustable gain factors (PAV+ after at least 36 h on passive mechanical ventilation. PAV+ was continued for 48 h until the patients met pre-defined criteria either for switching to controlled modes or for breathing without ventilator assistance. Data during passive mechanical ventilation and during PAV+ are reported. Data are acquired from the whole population, as well as from patients with and without acute respiratory distress syndrome. The reported variables are tidal volume, driving pressure (ΔP, the difference between static end-inspiratory plateau pressure and positive end-expiratory airway pressure, respiratory system compliance and resistance, and arterial blood gasses. The data are supplemental to our original research article, which described individual ΔP in these patients and examined how it related to ΔP when the same patients were ventilated with passive mechanical ventilation using the currently accepted lung-protective strategy “Driving pressure during assisted mechanical ventilation. Is it controlled by patient brain?” [1]. Keywords: Tidal volume, Compliance, Driving pressure

  17. Respiratory gated radiotherapy: current techniques and potential benefits

    International Nuclear Information System (INIS)

    Giraud, P.; Campana, F.; Rosenwald, J.C.; Cosset, J.M.; Reboul, F.; Garcia, R.; Clippe, S.; Carrie, C.; Dubray, B.

    2003-01-01

    Respiration-gated radiotherapy offers a significant potential for improvement in the irradiation of tumor sites affected by respiratory motion such as lung, breast and liver tumors. An increased conformality of irradiation fields leading to decreased complications rates of organs at risk (lung, heart...) is expected. Respiratory gating is in line with the need for improved precision required by radiotherapy techniques such as 3D conformal radiotherapy or intensity modulated radiotherapy. Reduction of respiratory motion can be achieved by using either breath hold techniques or respiration synchronized gating techniques. Breath-hold techniques can be achieved with active, in which airflow of the patient is temporarily blocked by a valve, or passive techniques, in which the patient voluntarily breath-hold. Synchronized gating techniques use external devices to predict the phase of the respiration cycle while the patient breaths freely. These techniques presently investigated in several medical centers worldwide. Although promising, the first results obtained in lung and liver cancer patients require confirmation. Physical, technical and physiological questions still remain to be answered. This paper describes the most frequently used gated techniques and the main published clinical reports on the use of respiration-gated radiotherapy in order to evaluate the impact of these techniques. (author)

  18. Ocular Tropism of Respiratory Viruses

    Science.gov (United States)

    Rota, Paul A.; Tumpey, Terrence M.

    2013-01-01

    SUMMARY Respiratory viruses (including adenovirus, influenza virus, respiratory syncytial virus, coronavirus, and rhinovirus) cause a broad spectrum of disease in humans, ranging from mild influenza-like symptoms to acute respiratory failure. While species D adenoviruses and subtype H7 influenza viruses are known to possess an ocular tropism, documented human ocular disease has been reported following infection with all principal respiratory viruses. In this review, we describe the anatomical proximity and cellular receptor distribution between ocular and respiratory tissues. All major respiratory viruses and their association with human ocular disease are discussed. Research utilizing in vitro and in vivo models to study the ability of respiratory viruses to use the eye as a portal of entry as well as a primary site of virus replication is highlighted. Identification of shared receptor-binding preferences, host responses, and laboratory modeling protocols among these viruses provides a needed bridge between clinical and laboratory studies of virus tropism. PMID:23471620

  19. Control and prevention of healthcare-associated tuberculosis: the role of respiratory isolation and personal respiratory protection.

    Science.gov (United States)

    Humphreys, H

    2007-05-01

    Although the prevalence of tuberculosis continues to decline in most developed countries, the risk of healthcare-associated tuberculosis, remains for patients or healthcare staff. Outbreaks of healthcare-associated tuberculosis are usually associated with delays in diagnosis and treatment, or the care of patients in sub-optimal facilities. The control and prevention of tuberculosis in hospitals is best achieved by three approaches, namely administrative (early investigation diagnosis, etc.), engineering (physical facilities e.g. ventilated isolation rooms) and personal respiratory protection (face sealing masks which are filtered). Recent guidelines on the prevention of tuberculosis in healthcare facilities from Europe and the USA have many common themes. In the UK, however, negative pressure isolation rooms are recommended only for patients with suspected multi-drug resistant TB and personal respiratory protection, i.e. filtered masks, are not considered necessary unless multi-drug resistant TB is suspected, or where aerosol-generating procedures are likely. In the US, the standard of care for patients with infectious tuberculosis is a negative pressure ventilated room and the use of personal respiratory protection for all healthcare workers entering the room of a patient with suspected or confirmed tuberculosis. The absence of clinical trials in this area precludes dogmatic recommendations. Nonetheless, observational studies and mathematical modelling suggest that all measures are required for effective prevention. Even when policies and facilities are optimal, there is a need to regularly review and audit these as sometimes compliance is less than optimal. The differences in recommendations may reflect the variations in epidemiology and the greater use of BCG vaccination in the UK compared with the United States. There is a strong argument for advising ventilated facilities and personal respiratory protection for the care of all patients with tuberculosis, as

  20. Examining the Gender Gap in Introductory Physics

    Science.gov (United States)

    Kost, Lauren; Pollock, Steven; Finkelstein, Noah

    2009-05-01

    Our previous research[1] showed that despite the use of interactive engagement techniques in the introductory physics course, the gap in performance between males and females on a mechanics conceptual learning survey persisted from pre- to post-test, at our institution. Such findings were counter to previously published work[2]. Follow-up studies[3] identified correlations between student performance on the conceptual learning survey and students' prior physics and math knowledge and their incoming attitudes and beliefs about physics and learning physics. The results indicate that the gender gap at our institution is predominantly associated with differences in males' and females' previous physics and math knowledge, and attitudes and beliefs. Our current work extends these results in two ways: 1) we look at the gender gap in the second semester of the introductory sequence and find results similar to those in the first semester course and 2) we identify ways in which males and females differentially experience several aspects of the introductory course. [1] Pollock, et al, Phys Rev: ST: PER 3, 010107. [2] Lorenzo, et al, Am J Phys 74, 118. [3] Kost, et al, PERC Proceedings 2008.

  1. Respiratory-Gated Positron Emission Tomography and Breath-Hold Computed Tomography Coupling to Reduce the Influence of Respiratory Motion: Methodology and Feasibility

    International Nuclear Information System (INIS)

    Daouk, J.; Fin, L.; Bailly, P.; Meyer, M.E.

    2009-01-01

    Background: Respiratory motion causes uptake in positron emission tomography (PET) images of chest and abdominal structures to be blurred and reduced in intensity. Purpose: To compare two respiratory-gated PET binning methods (based on frequency and amplitude analyses of the respiratory signal) and to propose a 'BH-based' method based on an additional breath-hold computed tomography (CT) acquisition. Material and Methods: Respiratory-gated PET consists in list-mode (LM) acquisition with simultaneous respiratory signal recording. A phantom study featured rectilinear movement of a 0.5-ml sphere filled with 18 F-fluorodeoxyglucose ( 18 F-FDG) solution, placed in a radioactive background (sphere-to-background contrast 6:1). Two patients were also examined. Three figures of merit were calculated: the target-to-background ratio profile (TBRP) in the axial direction through the uptake (i.e., the sphere or lesion), full-width-at-half-maximum (FWHM) values, and maximized standard uptake values (SUVmax). Results: In the phantom study, the peak TBRP was 0.9 for non-gated volume, 1.83 for BH-based volume, and varied between 1.13 and 1.73 for Freq-based volumes and between 1.34 and 1.66 for Amp-based volumes. A reference volume (REF-static) was also acquired for the phantom (in a static, 'expiratory' state), with a peak TBRP at 1.88. TBRPs were computed for patient data, with higher peak values for all gated volumes than for non-gated volumes. Conclusion: Respiratory-gated PET acquisition reduces the blurring effect and increases image contrast. However, Freq-based and Amp-based volumes are still influenced by inappropriate attenuation correction and misregistration of mobile lesions on CT images. The proposed BH-based method both reduces motion artifacts and improves PET-CT registration

  2. Tei index in neonatal respiratory distress and perinatal asphyxia

    Directory of Open Access Journals (Sweden)

    Ahmed Anwer Attia Khattab

    2015-09-01

    Full Text Available Cardiovascular compromise is a common complication of neonatal respiratory distress and perinatal asphyxia. Tei index is a Doppler-derived index for the assessment of overall left ventricular function that combines systolic and diastolic time intervals. Aim: Assess the role of MPI versus cardiac troponin I as early indicator of hypoxic cardiac damage in neonates with respiratory distress or perinatal asphyxia. The present work was conducted on forty neonates, 15 with neonatal respiratory distress (group I, 15 with perinatal asphyxia (group II, and 10 apparently healthy neonates as a control (group III. All have: Detailed history-thorough clinical examination-Plain X-ray-ECG-Two dimensional, M-mode and Doppler echocardiographic examination with the measurement of both myocardial performance index (MPI of the right and left ventricle-Serum cardiac troponin I. Results: There was statistically significant increase in serum cardiac troponin I in groups I and II than group III. Left and right ventricular myocardial performance index (MPI were increased in group I and II than the control group. No correlation between Tei index and each of postnatal age, apgar score at 5-min, heart rate, serum cardiac troponin I, ejection fraction and fractional shortening, but there was direct relationship between MPI and LVEDD and inverse relationship between MPI and each of EF% and FS%. But there was significant correlation between L.V. MPI and gestational age. Conclusion: Tei index was higher in neonates with respiratory distress and neonates with perinatal asphyxia than in normal neonates despite normal or even increased ejection fraction which indicates that these patients may have subclinical ventricular dysfunction which should be followed up carefully.

  3. Respiratory hospital admissions and weather changes: a retrospective study in Charlottesville, Virginia, USA

    Science.gov (United States)

    Davis, Robert E.; Enfield, Kyle B.

    2018-06-01

    In most midlatitude locations, human morbidity and mortality are highly seasonal, with winter peaks driven by respiratory disease and associated comorbidities. But the transition between high and low mortality/morbidity months varies spatially. We use a measure of the thermal biophysical strain imposed on the respiratory system—the Acclimatization Thermal Strain Index (ATSI)—to examine respiratory hospital admissions in Charlottesville, VA. Daily respiratory admissions to the University of Virginia over a 19-year period are compared to ATSI values derived from hourly surface weather data acquired from the Charlottesville airport. Negative ATSI values (associated with transitions from warm (and humid) to cold (and dry) conditions) are related to admission peaks at seasonal and weekly timescales, whereas positive ATSI values (cold to warm) exhibit weaker relationships. This research marks the first application of the ATSI to human morbidity, and results suggest that respiratory strain may account for how people who are acclimated to different climates respond to short-term weather changes.

  4. Respiratory hospital admissions and weather changes: a retrospective study in Charlottesville, Virginia, USA

    Science.gov (United States)

    Davis, Robert E.; Enfield, Kyle B.

    2018-02-01

    In most midlatitude locations, human morbidity and mortality are highly seasonal, with winter peaks driven by respiratory disease and associated comorbidities. But the transition between high and low mortality/morbidity months varies spatially. We use a measure of the thermal biophysical strain imposed on the respiratory system—the Acclimatization Thermal Strain Index (ATSI)—to examine respiratory hospital admissions in Charlottesville, VA. Daily respiratory admissions to the University of Virginia over a 19-year period are compared to ATSI values derived from hourly surface weather data acquired from the Charlottesville airport. Negative ATSI values (associated with transitions from warm (and humid) to cold (and dry) conditions) are related to admission peaks at seasonal and weekly timescales, whereas positive ATSI values (cold to warm) exhibit weaker relationships. This research marks the first application of the ATSI to human morbidity, and results suggest that respiratory strain may account for how people who are acclimated to different climates respond to short-term weather changes.

  5. Association of respiratory viruses with outcomes of severe childhood pneumonia in Botswana.

    Directory of Open Access Journals (Sweden)

    Matthew S Kelly

    Full Text Available The highest incidence of childhood acute lower respiratory tract infection (ALRI is in low- and middle-income countries. Few studies examined whether detection of respiratory viruses predicts ALRI outcomes in these settings.We conducted prospective cohort and case-control studies of children 1-23 months of age in Botswana. Cases met clinical criteria for pneumonia and were recruited within six hours of presentation to a referral hospital. Controls were children without pneumonia matched to cases by primary care clinic and date of enrollment. Nasopharyngeal specimens were tested for respiratory viruses using polymerase chain reaction. We compared detection rates of specific viruses in matched case-control pairs. We examined the effect of respiratory syncytial virus (RSV and other respiratory viruses on pneumonia outcomes.Between April 2012 and August 2014, we enrolled 310 cases, of which 133 had matched controls. Median ages of cases and controls were 6.1 and 6.4 months, respectively. One or more viruses were detected from 75% of cases and 34% of controls. RSV and human metapneumovirus were more frequent among cases than controls, but only enterovirus/rhinovirus was detected from asymptomatic controls. Compared with non-RSV viruses, RSV was associated with an increased risk of treatment failure at 48 hours [risk ratio (RR: 1.85; 95% confidence interval (CI: 1.20, 2.84], more days of respiratory support [mean difference (MD: 1.26 days; 95% CI: 0.30, 2.22 days], and longer duration of hospitalization [MD: 1.35 days; 95% CI: 0.20, 2.50 days], but lower in-hospital mortality [RR: 0.09; 95% CI: 0.01, 0.80] in children with pneumonia.Respiratory viruses were detected from most children hospitalized with ALRI in Botswana, but only RSV and human metapneumovirus were more frequent than among children without ALRI. Detection of RSV from children with ALRI predicted a protracted illness course but lower mortality compared with non-RSV viruses.

  6. Barriers to undergraduate peer-physical examination of the lower limb in the health sciences and strategies to improve inclusion: a review.

    Science.gov (United States)

    Hendry, Gordon James

    2013-10-01

    Peer-physical examination is a widely adopted and an integral component of the undergraduate curriculum for many health science programs. Unwillingness or perceived inability to participate in peer-physical examination classes may have a negative impact upon students' abilities to competently conduct physical examinations of patients in future as registered health professionals. A literature review on the perceptions and attitudes of peer-physical examination of the lower limb amongst medical and health science students was conducted to identify potential barriers to participation, and to review strategies to improve participation in classes designed to develop clinical examination skills. A pragmatic search strategy of the literature from PubMed and Google Scholar published prior to June 2012 yielded 23 relevant articles. All articles were concerned with the views of medical students' education and there were no articles explicitly addressing the role of peer-physical examination in health science disciplines. Several ethical issues were identified including feelings of coercion, embarrassment, and perceptions of a lack of consideration for cultural and religious beliefs. The available evidence suggests that barriers to participation may be overcome by implementing standard protocols concerned with obtaining informed written consent, adequate choice of peer-examiner, changing facilities and garment advice, and possible alternative learning methods.

  7. Yield of yearly routine physical examination in HIV-1 infected patients is limited : A retrospective cohort study in the Netherlands

    NARCIS (Netherlands)

    van Amsterdam, Marleen A.; van Assen, Sander; Sprenger, Herman G.; Wilting, Kasper R.; Stienstra, Ymkje; Bierman, Wouter F. W.

    2017-01-01

    Background Routine physical examinations might be of value in HIV-infected patients, but the yield is unknown. We determined the diagnoses that would have been missed without performing annual routine physical examinations in HIV-infected patients with stable disease. Methods Data were collected

  8. Health outcomes associated with lung function decline and respiratory symptoms and disease in a community cohort

    DEFF Research Database (Denmark)

    Baughman, Penelope; Marott, Jacob L; Lange, Peter

    2011-01-01

    in relation to asthma, chronic bronchitis, shortness of breath, and lung function level at examination 2 (1981-1983) or lung function decline established from examinations 1 (1976-1978) to 2 using 4 measures (FEV(1) slope, FEV(1) relative slope, American College of Occupational and Environmental Medicine......BACKGROUND: In workplace respiratory disease prevention, a thorough understanding is needed of the relative contributions of lung function loss and respiratory symptoms in predicting adverse health outcomes. METHODS: Copenhagen City Heart Study respiratory data collected at 4 examinations (1976......, the increasing trend in the HR (95% CI) by quartiles of the FEV(1) slope reached a maximum of 3.77 (2.76-5.15) for males, 6.12 (4.63-8.10) for females, and 4.14 (1.57-10.90) for never-smokers. Significant increasing trends were also observed for mortality, with females at higher risk. CONCLUSION: Lung function...

  9. Examining the effects of testwiseness in conceptual physics evaluations

    Science.gov (United States)

    DeVore, Seth; Stewart, John; Stewart, Gay

    2016-12-01

    Testwiseness is defined as the set of cognitive strategies used by a student that is intended to improve his or her score on a test regardless of the test's subject matter. Questions with elements that may be affected by testwiseness are common in physics assessments, even in those which have been extensively validated and widely used as evaluation tools in physics education research. The potential effect of several elements of testwiseness were analyzed for questions in the Force Concept Inventory (FCI) and Conceptual Survey on Electricity and Magnetism that contain distractors that are predicted to be influenced by testwiseness. This analysis was performed using data sets collected between fall 2001 and spring 2014 at one midwestern U.S. university (including over 9500 students) and between Spring 2011 and Spring 2015 at a second eastern U.S. university (including over 2500 students). Student avoidance of "none of the above" or "zero" distractors was statistically significant. The effect of the position of a distractor on its likelihood to be selected was also significant. The effects of several potential positive and negative testwiseness effects on student scores were also examined by developing two modified versions of the FCI designed to include additional elements related to testwiseness; testwiseness produced little effect post-instruction in student performance on the modified instruments.

  10. International consensus on the most useful physical examination tests used by physiotherapists for patients with headache: A Delphi study.

    Science.gov (United States)

    Luedtke, K; Boissonnault, W; Caspersen, N; Castien, R; Chaibi, A; Falla, D; Fernández-de-Las-Peñas, C; Hall, T; Hirsvang, J R; Horre, T; Hurley, D; Jull, G; Krøll, L S; Madsen, B K; Mallwitz, J; Miller, C; Schäfer, B; Schöttker-Königer, T; Starke, W; von Piekartz, H; Watson, D; Westerhuis, P; May, A

    2016-06-01

    A wide range of physical tests have been published for use in the assessment of musculoskeletal dysfunction in patients with headache. Which tests are used depends on a physiotherapist's clinical and scientific background as there is little guidance on the most clinically useful tests. To identify which physical examination tests international experts in physiotherapy consider the most clinically useful for the assessment of patients with headache. Delphi survey with pre-specified procedures based on a systematic search of the literature for physical examination tests proposed for the assessment of musculoskeletal dysfunction in patients with headache. Seventeen experts completed all three rounds of the survey. Fifteen tests were included in round one with eleven additional tests suggested by the experts. Finally eleven physical examination tests were considered clinically useful: manual joint palpation, the cranio-cervical flexion test, the cervical flexion-rotation test, active range of cervical movement, head forward position, trigger point palpation, muscle tests of the shoulder girdle, passive physiological intervertebral movements, reproduction and resolution of headache symptoms, screening of the thoracic spine, and combined movement tests. Eleven tests are suggested as a minimum standard for the physical examination of musculoskeletal dysfunctions in patients with headache. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. Physical activity and depression symptoms among pregnant women from the National Health and Nutrition Examination Survey 2005-2006.

    Science.gov (United States)

    Loprinzi, Paul D; Fitzgerald, Elizabeth M; Cardinal, Bradley J

    2012-03-01

    To examine the association between objectively measured physical activity and depression symptoms among a nationally representative sample of pregnant women to provide a more accurate understanding of the relationship between physical activity and depression symptoms. We employed a cross-sectional study design. Data from the National Health and Nutrition Examination Survey 2005-2006 were used for this study. One-hundred and forty-one pregnant women wore an ActiGraph accelerometer for 7 days and completed the Patient Health Questionnaire-9 to assess depression status. More than 19% of the participants experienced some depression symptoms, and compared to their counterparts not having depression symptoms, they were less physically active. An inverse association was found between physical activity and depression symptoms among pregnant women. When feasible, nurses are encouraged to help facilitate physical activity among pregnant women, assuming an uncomplicated pregnancy. © 2012 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

  12. Reliability of physical examination for diagnosis of myofascial trigger points: a systematic review of the literature.

    Science.gov (United States)

    Lucas, Nicholas; Macaskill, Petra; Irwig, Les; Moran, Robert; Bogduk, Nikolai

    2009-01-01

    Trigger points are promoted as an important cause of musculoskeletal pain. There is no accepted reference standard for the diagnosis of trigger points, and data on the reliability of physical examination for trigger points are conflicting. To systematically review the literature on the reliability of physical examination for the diagnosis of trigger points. MEDLINE, EMBASE, and other sources were searched for articles reporting the reliability of physical examination for trigger points. Included studies were evaluated for their quality and applicability, and reliability estimates were extracted and reported. Nine studies were eligible for inclusion. None satisfied all quality and applicability criteria. No study specifically reported reliability for the identification of the location of active trigger points in the muscles of symptomatic participants. Reliability estimates varied widely for each diagnostic sign, for each muscle, and across each study. Reliability estimates were generally higher for subjective signs such as tenderness (kappa range, 0.22-1.0) and pain reproduction (kappa range, 0.57-1.00), and lower for objective signs such as the taut band (kappa range, -0.08-0.75) and local twitch response (kappa range, -0.05-0.57). No study to date has reported the reliability of trigger point diagnosis according to the currently proposed criteria. On the basis of the limited number of studies available, and significant problems with their design, reporting, statistical integrity, and clinical applicability, physical examination cannot currently be recommended as a reliable test for the diagnosis of trigger points. The reliability of trigger point diagnosis needs to be further investigated with studies of high quality that use current diagnostic criteria in clinically relevant patients.

  13. Respiratory hospitalizations in association with fine PM and its ...

    Science.gov (United States)

    Despite observed geographic and temporal variation in particulate matter (PM)-related health morbidities, only a small number of epidemiologic studies have evaluated the relation between PM2.5 chemical constituents and respiratory disease. Most assessments are limited by inadequate spatial and temporal resolution of ambient PM measurements and/or by their approaches to examine the role of specific PM components on health outcomes. In a case-crossover analysis using daily average ambient PM2.5 total mass and species estimates derived from the Community Multiscale Air Quality (CMAQ) model and available observations, we examined the association between the chemical components of PM (including elemental and organic carbon, sulfate, nitrate, ammonium, and other remaining) and respiratory hospitalizations in New York State. We evaluated relationships between levels (low, medium, high) of PM constituent mass fractions, and assessed modification of the PM2.5–hospitalization association via models stratified by mass fractions of both primary and secondary PM components. In our results, average daily PM2.5 concentrations in New York State were generally lower than the 24-hr average National Ambient Air Quality Standard (NAAQS). Year-round analyses showed statistically significant positive associations between respiratory hospitalizations and PM2.5 total mass, sulfate, nitrate, and ammonium concentrations at multiple exposure lags (0.5–2.0% per interquartile range [IQR

  14. Acquiring a four-dimensional computed tomography dataset using an external respiratory signal

    International Nuclear Information System (INIS)

    Vedam, S S; Keall, P J; Kini, V R; Mostafavi, H; Shukla, H P; Mohan, R

    2003-01-01

    Four-dimensional (4D) methods strive to achieve highly conformal radiotherapy, particularly for lung and breast tumours, in the presence of respiratory-induced motion of tumours and normal tissues. Four-dimensional radiotherapy accounts for respiratory motion during imaging, planning and radiation delivery, and requires a 4D CT image in which the internal anatomy motion as a function of the respiratory cycle can be quantified. The aims of our research were (a) to develop a method to acquire 4D CT images from a spiral CT scan using an external respiratory signal and (b) to examine the potential utility of 4D CT imaging. A commercially available respiratory motion monitoring system provided an 'external' tracking signal of the patient's breathing. Simultaneous recording of a TTL 'X-Ray ON' signal from the CT scanner indicated the start time of CT image acquisition, thus facilitating time stamping of all subsequent images. An over-sampled spiral CT scan was acquired using a pitch of 0.5 and scanner rotation time of 1.5 s. Each image from such a scan was sorted into an image bin that corresponded with the phase of the respiratory cycle in which the image was acquired. The complete set of such image bins accumulated over a respiratory cycle constitutes a 4D CT dataset. Four-dimensional CT datasets of a mechanical oscillator phantom and a patient undergoing lung radiotherapy were acquired. Motion artefacts were significantly reduced in the images in the 4D CT dataset compared to the three-dimensional (3D) images, for which respiratory motion was not accounted. Accounting for respiratory motion using 4D CT imaging is feasible and yields images with less distortion than 3D images. 4D images also contain respiratory motion information not available in a 3D CT image

  15. The peculiarities of food allergies in accordance with the level of injury of respiratory tract in children of Eastern Siberia.

    Science.gov (United States)

    Borisova, Irina V; Smirnova, Svetlana V

    2013-01-01

    To determine the course of food allergy in accordance with the level of respiratory tract injury in children of Eastern Siberia. We have examined 70 children aged 2-16 , who have food sensibilization. We divided them into 2 groups: group I (n = 32) with diseases of the upper and middle respiratory tract; and group II (n = 38) with diseases of the lower respiratory tract. Allergological medical history, clinical laboratory examination and immunological examination, including the determination of IgA, IgM, IgG and IgE in blood serum. In cases where causal allergens were found, elimination diets were recommended. Onset of upper respiratory tract injury in group I was more often registered in children aged 0-1; in group II, it was in the 3-7 age group. Isolated food sensibilization was more often marked in group I as compared to group II. Atopic mechanisms of respiratory tract injuries were more often registered in group II children. In the course of the elimination diet, we marked positive dynamics in 100% of group I and in 75% of group II. The most frequent allergens that cause respiratory forms of food allergy are hen eggs, cow milk, nutritive cereals, vegetables and fruit. Indices of a humoral link of immunity in the examined patients were more often registered as normal or their level is increased. Timely etiotropic therapy in the majority of cases allows for a stabilization of allergic inflammation.

  16. Psychogenic Explanations of Physical Illness: Time to Examine the Evidence.

    Science.gov (United States)

    Wilshire, Carolyn E; Ward, Tony

    2016-09-01

    In some patients with chronic physical complaints, detailed examination fails to reveal a well-recognized underlying disease process. In this situation, the physician may suspect a psychological cause. In this review, we critically evaluated the evidence for this causal claim, focusing on complaints presenting as neurological disorders. There were four main conclusions. First, patients with these complaints frequently exhibit psychopathology but not consistently more often than patients with a comparable "organic" diagnosis, so a causal role cannot be inferred. Second, these patients report a high incidence of adverse life experiences, but again, there is insufficient evidence to indicate a causal role for any particular type of experience. Third, although psychogenic illnesses are believed to be more responsive to psychological interventions than comparable "organic" illnesses, there is currently no evidence to support this claim. Finally, recent evidence suggests that biological and physical factors play a much greater causal role in these illnesses than previously believed. We conclude that there is currently little evidential support for psychogenic theories of illness in the neurological domain. In future research, researchers need to take a wider view concerning the etiology of these illnesses. © The Author(s) 2016.

  17. Dysrhythmias of the respiratory oscillator

    Science.gov (United States)

    Paydarfar, David; Buerkel, Daniel M.

    1995-03-01

    Breathing is regulated by a central neural oscillator that produces rhythmic output to the respiratory muscles. Pathological disturbances in rhythm (dysrhythmias) are observed in the breathing pattern of children and adults with neurological and cardiopulmonary diseases. The mechanisms responsible for genesis of respiratory dysrhythmias are poorly understood. The present studies take a novel approach to this problem. The basic postulate is that the rhythm of the respiratory oscillator can be altered by a variety of stimuli. When the oscillator recovers its rhythm after such perturbations, its phase may be reset relative to the original rhythm. The amount of phase resetting is dependent upon stimulus parameters and the level of respiratory drive. The long-range hypothesis is that respiratory dysrhythmias can be induced by stimuli that impinge upon or arise within the respiratory oscillator with certain combinations of strength and timing relative to the respiratory cycle. Animal studies were performed in anesthetized or decerebrate preparations. Neural respiratory rhythmicity is represented by phrenic nerve activity, allowing use of open-loop experimental conditions which avoid negative chemical feedback associated with changes in ventilation. In animal experiments, respiratory dysrhythmias can be induced by stimuli having specific combinations of strength and timing. Newborn animals readily exhibit spontaneous dysrhythmias which become more prominent at lower respiratory drives. In human subjects, swallowing was studied as a physiological perturbation of respiratory rhythm, causing a pattern of phase resetting that is characterized topologically as type 0. Computational studies of the Bonhoeffer-van der Pol (BvP) equations, whose qualitative behavior is representative of many excitable systems, supports a unified interpretation of these experimental findings. Rhythmicity is observed when the BvP model exhibits recurrent periods of excitation alternating with

  18. A narrative review of evidence-based recommendations for the physical examination of the lumbar spine, sacroiliac and hip joint complex.

    Science.gov (United States)

    Wong, C K; Johnson, E K

    2012-09-01

    Non-specific low back pain is a frequent complaint in primary care, but the differential diagnosis for low back pain can be complex. Despite advances in diagnostic imaging, a specific pathoanatomical source of low back pain can remain elusive in up to 85% of individuals. Best practice guidelines recommend that clinicians conduct a focused physical examination to help to identify patients with non-specific low back pain and an evidence-based course of clinical management. The use of sensitive and specific clinical methods to assess the lumbar spine, sacroiliac and hip joints is critical for effective physical examination. Psychosocial factors also play an important role in the evaluation of individuals with low back pain, but are not included in this narrative review of physical examination methods. Physical examination of the lumbar spine, sacroiliac and hip joints is presented, organized around patient position for efficient and effective clinical assessment. Copyright © 2012 John Wiley & Sons, Ltd.

  19. Pneumoconiosis and respiratory problems in dental laboratory technicians: Analysis of 893 dental technicians

    Directory of Open Access Journals (Sweden)

    Dilek Ergün

    2014-10-01

    Full Text Available Objectives: To explore the rate of pneumoconiosis in dental technicians (DTP and to evaluate the risk factors. Material and Methods: Data of 893 dental technicians, who were admitted to our hospital in the period January 2007–May 2012, from 170 dental laboratories were retrospectively examined. Demographic data, respiratory symptoms, smoking status, work duration, working fields, exposure to sandblasting, physical examination findings, chest radiographs, pulmonary function tests and high-resolution computed tomography results were evaluated. Results: Dental technicians’ pneumoconiosis rate was 10.1% among 893 cases. The disease was more common among males and in those exposed to sandblasting who had 77-fold higher risk of DTP. The highest profusion subcategory was 3/+ (according to the International Labour Organization (ILO 2011 standards and the large opacity rate was 13.3%. Conclusions: To the best of our knowledge, it was the largest DTP case series (N = 893/90 in the literature in English. Health screenings should be performed regularly for the early diagnosis of pneumoconiosis, which is an important occupational disease for dental technicians.

  20. The Effects of Music during a Physical Examination Skills Practice: A Pilot Study.

    Science.gov (United States)

    Artemiou, Elpida; Gilbert, Gregory E; Sithole, Fortune; Koster, Liza S

    2017-09-27

    Some veterinary students experience elevated stress, anxiety, and depression resulting in disease and psychological changes. Elevated arousal, negative moods, and lack of interest can negatively affect performance and learning. Psychoacoustic music promotes calming effects using simple and slow piano sounds and can positively impact well-being and functioning. This pilot study assessed the effects of music on blood pressure, pulse, arousal, and mood during a canine physical examination laboratory. In an AB/BA crossover study, 17 students were randomly allocated to practice physical examination skills while listening to Through a Dog's Ear, Volume 1 . Psychological and physiologic data were collected. Nonparametric methods were used to test for significant differences in psychological and physiologic data and a linear mixed models approach was used to test for physiological differences. There were no significant baseline differences between the music and no music groups for DASS-21 depression, anxiety, or stress scores; however, there were significant time differences between pretest and posttest on arousal and mood as measured by the Profile of Mood Sates (POMS) Depression, Fatigue-Inertia, and Tension Anxiety subscales. Linear mixed models revealed no significant treatment effect on the pulse and diastolic blood pressure; however, there was a significant systolic blood pressure treatment effect. Future indications include repeating the study with a larger sample to examine longitudinal psychological and physiological benefits.

  1. The Effects of Music during a Physical Examination Skills Practice: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Elpida Artemiou

    2017-09-01

    Full Text Available Some veterinary students experience elevated stress, anxiety, and depression resulting in disease and psychological changes. Elevated arousal, negative moods, and lack of interest can negatively affect performance and learning. Psychoacoustic music promotes calming effects using simple and slow piano sounds and can positively impact well-being and functioning. This pilot study assessed the effects of music on blood pressure, pulse, arousal, and mood during a canine physical examination laboratory. In an AB/BA crossover study, 17 students were randomly allocated to practice physical examination skills while listening to Through a Dog’s Ear, Volume 1. Psychological and physiologic data were collected. Nonparametric methods were used to test for significant differences in psychological and physiologic data and a linear mixed models approach was used to test for physiological differences. There were no significant baseline differences between the music and no music groups for DASS-21 depression, anxiety, or stress scores; however, there were significant time differences between pretest and posttest on arousal and mood as measured by the Profile of Mood Sates (POMS Depression, Fatigue–Inertia, and Tension Anxiety subscales. Linear mixed models revealed no significant treatment effect on the pulse and diastolic blood pressure; however, there was a significant systolic blood pressure treatment effect. Future indications include repeating the study with a larger sample to examine longitudinal psychological and physiological benefits.

  2. A quasi-experimental examination of how school-based physical activity changes impact secondary school student moderate- to vigorous- intensity physical activity over time in the COMPASS study

    OpenAIRE

    Hunter, Stephen; Leatherdale, Scott T.; Storey, Kate; Carson, Valerie

    2016-01-01

    Background Adolescence is characterized by low moderate- to vigorous- intensity physical activity (MVPA) levels. Targeting the school setting can increase MVPA among a large proportion of adolescents. However, school-based physical activity interventions for adolescents remain largely ineffective. Therefore, the purpose of this study was to examine how naturally-occurring changes to school physical activity policy, recreational programming, public health resources, and the physical environmen...

  3. Accuracy of physical examination in the diagnosis of hypothyroidism: a cross-sectional, double-blind study

    Directory of Open Access Journals (Sweden)

    Indra R

    2004-01-01

    Full Text Available Background: Hypothyroidism is a common, potentially treatable endocrine disorder. Since hypothyroidism is not always associated with the signs and symptoms typically attributed to it, the diagnosis is often missed. Conversely, patients with typical signs and symptoms may not have the disease when laboratory tests are performed. Aims: We aimed to determine the accuracy of physical examination in the diagnosis of hypothyroidism. Setting and design: Prospective, hospital-based, cross-sectional diagnostic study. Material and Methods: Consecutive outpatients from the medicine department were screened and an independent comparison of physical signs (coarse skin, puffy face, slow movements, bradycardia, pretibial oedema and ankle reflex against thyroid hormone assay (TSH and FT4 was performed. Statistical analysis: Diagnostic accuracy was measured as sensitivity, specificity, positive likelihood ratios, negative likelihood ratios and positive and negative predictive values. Results: Of the 1450 patients screened, 130 patients (102 women and 28 men underwent both clinical examination and thyroid function tests. Twenty-three patients (18% were diagnosed to have hypothyroidism by thyroid hormone assays. No single sign could easily discriminate a euthyroid from a hypothyroid patient (range of positive likelihood ratio (LR+ 1.0 to 3.88; range of negative likelihood ratio (LR-: 0.42 to 1.0. No physical sign generated a likelihood ratio large enough to increase the post-test probability significantly. The combination of signs that had the highest likelihood ratios (coarse skin, bradycardia and delayed ankle reflex was associated with modest accuracy (LR+ 3.75; LR- 0.48. Conclusion: Clinicians cannot rely exclusively on physical examination to confirm or rule out hypothyroidism. Patients with suspected hypothyroidism require a diagnostic workup that includes thyroid hormone assays.

  4. Parainfluenza virus as a cause of acute respiratory infection in hospitalized children.

    Science.gov (United States)

    Pecchini, Rogério; Berezin, Eitan Naaman; Souza, Maria Cândida; Vaz-de-Lima, Lourdes de Andrade; Sato, Neuza; Salgado, Maristela; Ueda, Mirthes; Passos, Saulo Duarte; Rangel, Raphael; Catebelota, Ana

    2015-01-01

    Human parainfluenza viruses account for a significant proportion of lower respiratory tract infections in children. To assess the prevalence of Human parainfluenza viruses as a cause of acute respiratory infection and to compare clinical data for this infection against those of the human respiratory syncytial virus. A prospective study in children younger than five years with acute respiratory infection was conducted. Detection of respiratory viruses in nasopharyngeal aspirate samples was performed using the indirect immunofluorescence reaction. Length of hospital stay, age, clinical history and physical exam, clinical diagnoses, and evolution (admission to Intensive Care Unit or general ward, discharge or death) were assessed. Past personal (premature birth and cardiopathy) as well as family (smoking and atopy) medical factors were also assessed. A total of 585 patients were included with a median age of 7.9 months and median hospital stay of six days. No difference between the HRSV+ and HPIV+ groups was found in terms of age, gender or length of hospital stay. The HRSV+ group had more fever and cough. Need for admission to the Intensive Care Unit was similar for both groups but more deaths were recorded in the HPIV+ group. The occurrence of parainfluenza peaked during the autumn in the first two years of the study. Parainfluenza was responsible for significant morbidity, proving to be the second-most prevalent viral agent in this population after respiratory syncytial virus. No difference in clinical presentation was found between the two groups, but mortality was higher in the HPIV+ group. Copyright © 2015. Published by Elsevier Editora Ltda.

  5. Força muscular respiratória e capacidade funcional em idosas hipertensas com sonolência diurna excessiva Respiratory muscle strength and physical fitness in hypertensive elderly women with excessive daytime sleepiness

    Directory of Open Access Journals (Sweden)

    Rafaela Pedrosa

    2010-06-01

    Full Text Available O objetivo do estudo foi verificar se a sonolência diurna excessiva (SDE afeta a capacidade funcional (CF e força muscular respiratória entre idosas hipertensas. O estudo avaliou 32 idosas hipertensas, divididas em dois grupos (com SDE, n=17, 64,9±5,3 anos; e sem SDE, n=15, 65,9±5,5 anos, quanto a: força muscular respiratória, por manovacuometria; CF, pelo Questionário para avaliação de limitação das atividades e por testes de aptidão funcional; nível de atividade física, pelo questionário internacional de atividade física IPAQ; grau de SDE, pela escala de sonolência de Epworth; qualidade do sono, pelo índice de qualidade do sono de Pittsburgh; e intensidade do ronco, pela escala de ronco de Stanford. Os dois grupos, homogêneos quanto a características antropométricas e da hipertensão, foram comparados estatisticamente quanto a parâmetros de sono, pressões respiratórias máximas, nível de atividade física e CF. Foi encontrada diferença significativa na qualidade do sono (p=0,03, tendo as hipertensas com SDE qualidade de sono muito ruim; porém não foram encontradas diferenças significativas entre os grupos nas pressões inspiratória e expiratória máximas, nem quanto aos testes de CF. Conclui-se que a força dos músculos respiratórios não sofre alteração em decorrência da presença de SDE em idosas hipertensas e que essa sonolência não interfere na capacidade funcional.The purpose of the study was to inquire whether excessive daytime sleepiness (EDS affects functional capacity (FC and respiratory muscle strength in elderly hypertensive patients. Thirty-two elderly hypertensive female patients were divided into two groups (with EDS, n=17, mean age 64.9±5.3; without EDS, n=15, mean age 65.9±5.5 and were assessed as to respiratory muscle strength by spirometry; FC, by the Questionnaire on limitations in physical activities and by functional fitness tests; physical activity level, by the International

  6. Respiratory effort from the photoplethysmogram.

    Science.gov (United States)

    Addison, Paul S

    2017-03-01

    The potential for a simple, non-invasive measure of respiratory effort based on the pulse oximeter signal - the photoplethysmogram or 'pleth' - was investigated in a pilot study. Several parameters were developed based on a variety of manifestations of respiratory effort in the signal, including modulation changes in amplitude, baseline, frequency and pulse transit times, as well as distinct baseline signal shifts. Thirteen candidate parameters were investigated using data from healthy volunteers. Each volunteer underwent a series of controlled respiratory effort maneuvers at various set flow resistances and respiratory rates. Six oximeter probes were tested at various body sites. In all, over three thousand pleth-based effort-airway pressure (EP) curves were generated across the various airway constrictions, respiratory efforts, respiratory rates, subjects, probe sites, and the candidate parameters considered. Regression analysis was performed to determine the existence of positive monotonic relationships between the respiratory effort parameters and resulting airway pressures. Six of the candidate parameters investigated exhibited a distinct positive relationship (poximeter probe and an ECG (P2E-Effort) and the other using two pulse oximeter probes placed at different peripheral body sites (P2-Effort); and baseline shifts in heart rate, (BL-HR-Effort). In conclusion, a clear monotonic relationship was found between several pleth-based parameters and imposed respiratory loadings at the mouth across a range of respiratory rates and flow constrictions. The results suggest that the pleth may provide a measure of changing upper airway dynamics indicative of the effort to breathe. Copyright © 2017 The Author. Published by Elsevier Ltd.. All rights reserved.

  7. Respiratory Epithelium Lined Cyst of the Maxilla: Differential Diagnosis

    Directory of Open Access Journals (Sweden)

    C. P. Martinelli-Kläy

    2017-01-01

    Full Text Available Maxillary cysts, including the cysts lined by respiratory epithelium, can present a diagnostic challenge. We report an unusual case of a maxillary cyst on an endodontically treated tooth #16, in which the cavity was totally lined by a respiratory epithelium. The patient, a 35-year-old male, presented with a generalized chronic periodontitis and complained of a pain in the tooth #16 region. A periodontal pocket extending to the root apices with pus coming out from the gingival was found. A combined endodontic periodontal was observed on a panoramic radiography. CBCT-scan revealed a well-circumscribed radiolucent lesion at the apices of the distobuccal root of the 16. A communication with the right maxillary sinus cavity and a maxillary and ethmoidal sinusitis were also observed. The lesion was removed and histological examination revealed a cyst lined exclusively by respiratory epithelium. Ciliated and rare mucous cells were also observed. The diagnosis could evoke a surgical ciliated cyst mimicking the radicular cyst but the patient has no previous history of trauma or surgery in the maxillofacial region. It could also be an unusual radicular cyst in which the stratified squamous epithelium was destroyed by inflammation and replaced by a respiratory epithelium of the maxillary sinus.

  8. Detection of viruses and atypical bacteria associated with acute respiratory infection of children in Hubei, China.

    Science.gov (United States)

    Wu, Zegang; Li, Yan; Gu, Jian; Zheng, Hongyun; Tong, Yongqing; Wu, Qing

    2014-02-01

    Acute respiratory infection is the major cause of disease and death in children, particularly in developing countries. However, the spectrum of pathogenic viruses and atypical bacteria that exist in many of these countries remains incompletely characterized. The aim of this study was to examine the spectrum of pathogenic viruses and atypical bacteria associated with acute respiratory infection in children under the age of 16. A total of 10 435 serum sera specimens were collected from hospitalized children presenting with acute respiratory infection symptoms. Indirect immunofluorescence assays were performed to detect immunoglobulin M antibodies against nine common pathogens: mycoplasma pneumonia, influenza virus B, respiratory syncytial virus, parainfluenza virus, adenovirus, influenza virus A, legionella pneumophila, coxiella burnetii and chamydophila pneumonia. Of the 10 435 specimens examined, 7046 tested positive for at least one pathogen. Among all of the tested pathogens, mycoplasma pneumonia had the highest detection rate (56.9%). Influenza virus A and influenza virus B epidemics occurred during both winter and summer. The detection rate of respiratory syncytial virus and adenovirus was higher in spring. Cases of mixed infection were more complex: 4136 specimens (39.6%) tested positive for ≥2 pathogens. There were statistically significant difference in detection rates of mycoplasma pneumonia, influenza virus B, respiratory syncytial virus, parainfluenza virus, adenovirus, influenza virus A, legionella pneumophila and chamydophila pneumonia among different age groups (P acute respiratory infection among children in Hubei of China were mycoplasma pneumonia, influenza virus B and respiratory syncytial virus. The detection rates for each pathogen displayed specific seasonal and age group variations. © 2013 The Authors. Respirology © 2013 Asian Pacific Society of Respirology.

  9. Emergency Medicine Evaluation of Community-Acquired Pneumonia: History, Examination, Imaging and Laboratory Assessment, and Risk Scores.

    Science.gov (United States)

    Long, Brit; Long, Drew; Koyfman, Alex

    2017-11-01

    Pneumonia is a common infection, accounting for approximately one million hospitalizations in the United States annually. This potentially life-threatening disease is commonly diagnosed based on history, physical examination, and chest radiograph. To investigate emergency medicine evaluation of community-acquired pneumonia including history, physical examination, imaging, and the use of risk scores in patient assessment. Pneumonia is the number one cause of death from infectious disease. The condition is broken into several categories, the most common being community-acquired pneumonia. Diagnosis centers on history, physical examination, and chest radiograph. However, all are unreliable when used alone, and misdiagnosis occurs in up to one-third of patients. Chest radiograph has a sensitivity of 46-77%, and biomarkers including white blood cell count, procalcitonin, and C-reactive protein provide little benefit in diagnosis. Biomarkers may assist admitting teams, but require further study for use in the emergency department. Ultrasound has shown utility in correctly identifying pneumonia. Clinical gestalt demonstrates greater ability to diagnose pneumonia. Clinical scores including Pneumonia Severity Index (PSI); Confusion, blood Urea nitrogen, Respiratory rate, Blood pressure, age 65 score (CURB-65); and several others may be helpful for disposition, but should supplement, not replace, clinical judgment. Patient socioeconomic status must be considered in disposition decisions. The diagnosis of pneumonia requires clinical gestalt using a combination of history and physical examination. Chest radiograph may be negative, particularly in patients presenting early in disease course and elderly patients. Clinical scores can supplement clinical gestalt and assist in disposition when used appropriately. Published by Elsevier Inc.

  10. Examining a conceptual model of parental nurturance, parenting practices and physical activity among 5–6 year olds

    Science.gov (United States)

    Sebire, Simon J.; Jago, Russell; Wood, Lesley; Thompson, Janice L.; Zahra, Jezmond; Lawlor, Deborah A.

    2016-01-01

    Rationale Parenting is an often-studied correlate of children's physical activity, however there is little research examining the associations between parenting styles, practices and the physical activity of younger children. Objective This study aimed to investigate whether physical activity-based parenting practices mediate the association between parenting styles and 5–6 year-old children's objectively-assessed physical activity. Methods 770 parents self-reported parenting style (nurturance and control) and physical activity-based parenting practices (logistic and modeling support). Their 5–6 year old child wore an accelerometer for five days to measure moderate-to-vigorous physical activity (MVPA). Linear regression was used to examine direct and indirect (mediation) associations. Data were collected in the United Kingdom in 2012/13 and analyzed in 2014. Results Parent nurturance was positively associated with provision of modeling (adjusted unstandardized coefficient, β = 0.11; 95% CI = 0.02, 0.21) and logistic support (β = 0.14; 0.07, 0.21). Modeling support was associated with greater child MVPA (β = 2.41; 0.23, 4.60) and a small indirect path from parent nurturance to child's MVPA was identified (β = 0.27; 0.04, 0.70). Conclusions Physical activity-based parenting practices are more strongly associated with 5–6 year old children's MVPA than parenting styles. Further research examining conceptual models of parenting is needed to understand in more depth the possible antecedents to adaptive parenting practices beyond parenting styles. PMID:26647364

  11. Auditory and Respiratory Health Disorders Among Workers in an ...

    African Journals Online (AJOL)

    For early detection of respiratory and auditory disorders, spirometry and audiometry should be included in the periodic medical examination. Accurate health records of workers, so, those at risk can be monitored, and/or pre-placed. Using personal protective equipments especially masks and ear muffles as well as prohibit ...

  12. Respiratory problems in children with esophageal atresia and tracheoesophageal fistula.

    Science.gov (United States)

    Porcaro, Federica; Valfré, Laura; Aufiero, Lelia Rotondi; Dall'Oglio, Luigi; De Angelis, Paola; Villani, Alberto; Bagolan, Pietro; Bottero, Sergio; Cutrera, Renato

    2017-09-05

    Children with congenital esophageal atresia (EA) and tracheoesophageal fistula (TEF) have chronic respiratory symptoms including recurrent pneumonia, wheezing and persistent cough. The aim of this study is to describe the clinical findings of a large group of children with EA and TEF surgically corrected and the instrumental investigation to which they have undergone in order to better understand the patient's needs and harmonize the care. A retrospective data collection was performed on 105 children with EA and TEF followed at Department of Pediatric Medicine of Bambino Gesù Children's Hospital (Rome, Italy) between 2010 and 2015. 69/105 (66%) children reported lower respiratory symptoms with a mean age onset of 2.2 ± 2.5 years and only 63/69 (91%) performed specialist assessment at Respiratory Unit. Recurrent pneumonia (33%) and wheezing (31%) were the most reported symptoms. The first respiratory evaluation was performed after surgically correction of gastroesophageal reflux (GER) at mean age of 3.9 ± 4.2 years. Twenty nine patients have undergone to chest CT with contrast enhancement detecting localized atelectasis (41%), residual tracheal diverticulum (34%), bronchiectasis (31%), tracheal vascular compression (21%), tracheomalacia (17%) and esophageal diverticulum (14%). Fifty three patients have undergone to airways endoscopy detecting tracheomalacia (66%), residual tracheal diverticulum (26%), recurrent tracheoesophageal fistula (19%) and vocal cord paralysis (11%). Our study confirms that respiratory symptoms often complicate EA and TEF; their persistence despite medical and surgical treatment of GER means that other etiological hypothesis must be examined and that a complete respiratory diagnostic work up must be considered.

  13. Human metapneumovirus and respiratory syncytial virus in hospitalized danish children with acute respiratory tract infection

    DEFF Research Database (Denmark)

    von Linstow, Marie-Louise; Henrik Larsen, Hans; Koch, Anders

    2004-01-01

    The newly discovered human metapneumovirus (hMPV) has been shown to be associated with respiratory illness. We determined the frequencies and clinical features of hMPV and respiratory syncytial virus (RSV) infections in 374 Danish children with 383 episodes of acute respiratory tract infection...... children 1-6 months of age. Asthmatic bronchitis was diagnosed in 66.7% of hMPV and 10.6% of RSV-infected children (p respiratory support. hMPV is present in young...

  14. Diagnostic accuracy of history, physical examination, and bedside ultrasound for diagnosis of extremity fractures in the emergency department: a systematic review.

    Science.gov (United States)

    Joshi, Nikita; Lira, Alena; Mehta, Ninfa; Paladino, Lorenzo; Sinert, Richard

    2013-01-01

    Understanding history, physical examination, and ultrasonography (US) to diagnose extremity fractures compared with radiography has potential benefits of decreasing radiation exposure, costs, and pain and improving emergency department (ED) resource management and triage time. The authors performed two electronic searches using PubMed and EMBASE databases for studies published between 1965 to 2012 using a strategy based on the inclusion of any patient presenting with extremity injuries suspicious for fracture who had history and physical examination and a separate search for US performed by an emergency physician (EP) with subsequent radiography. The primary outcome was operating characteristics of ED history, physical examination, and US in diagnosing radiologically proven extremity fractures. The methodologic quality of the studies was assessed using the quality assessment of studies of diagnostic accuracy tool (QUADAS-2). Nine studies met the inclusion criteria for history and physical examination, while eight studies met the inclusion criteria for US. There was significant heterogeneity in the studies that prevented data pooling. Data were organized into subgroups based on anatomic fracture locations, but heterogeneity within the subgroups also prevented data pooling. The prevalence of fracture varied among the studies from 22% to 70%. Upper extremity physical examination tests have positive likelihood ratios (LRs) ranging from 1.2 to infinity and negative LRs ranging from 0 to 0.8. US sensitivities varied between 85% and 100%, specificities varied between 73% and 100%, positive LRs varied between 3.2 and 56.1, and negative LRs varied between 0 and 0.2. Compared with radiography, EP US is an accurate diagnostic test to rule in or rule out extremity fractures. The diagnostic accuracy for history and physical examination are inconclusive. Future research is needed to understand the accuracy of ED US when combined with history and physical examination for upper

  15. LUDEP 1. 0, a personal computer program to implement the new ICRP respiratory tract model

    Energy Technology Data Exchange (ETDEWEB)

    Jarvis, N.S.; Birchall, A. (National Radiological Protection Board, Chilton (United Kingdom))

    1994-01-01

    The International Commission on Radiological Protection has recently approved a new model of the human respiratory tract. This model has been designed to represent realistically the deposition and biokinetic behaviour of inhaled radionuclides, and to calculate doses to the respiratory tract. In order to examine the practical application and radiological implications of the new model, a Personal Computer program has been developed. LUDEP 1.0 is a user-friendly program for the IBM-compatible PC which enables the user to calculate doses to the respiratory tract and to other organs. (author).

  16. Increased respiratory neural drive and work of breathing in exercise-induced laryngeal obstruction.

    Science.gov (United States)

    Walsted, Emil S; Faisal, Azmy; Jolley, Caroline J; Swanton, Laura L; Pavitt, Matthew J; Luo, Yuan-Ming; Backer, Vibeke; Polkey, Michael I; Hull, James H

    2018-02-01

    Exercise-induced laryngeal obstruction (EILO), a phenomenon in which the larynx closes inappropriately during physical activity, is a prevalent cause of exertional dyspnea in young individuals. The physiological ventilatory impact of EILO and its relationship to dyspnea are poorly understood. The objective of this study was to evaluate exercise-related changes in laryngeal aperture on ventilation, pulmonary mechanics, and respiratory neural drive. We prospectively evaluated 12 subjects (6 with EILO and 6 healthy age- and gender-matched controls). Subjects underwent baseline spirometry and a symptom-limited incremental exercise test with simultaneous and synchronized recording of endoscopic video and gastric, esophageal, and transdiaphragmatic pressures, diaphragm electromyography, and respiratory airflow. The EILO and control groups had similar peak work rates and minute ventilation (V̇e) (work rate: 227 ± 35 vs. 237 ± 35 W; V̇e: 103 ± 20 vs. 98 ± 23 l/min; P > 0.05). At submaximal work rates (140-240 W), subjects with EILO demonstrated increased work of breathing ( P respiratory neural drive ( P respiratory mechanics and diaphragm electromyography with endoscopic video, we demonstrate, for the first time, increased work of breathing and respiratory neural drive in association with the development of EILO. Future detailed investigations are now needed to understand the role of upper airway closure in causing exertional dyspnea and exercise limitation. NEW & NOTEWORTHY Exercise-induced laryngeal obstruction is a prevalent cause of exertional dyspnea in young individuals; yet, how laryngeal closure affects breathing is unknown. In this study we synchronized endoscopic video with respiratory physiological measurements, thus providing the first detailed commensurate assessment of respiratory mechanics and neural drive in relation to laryngeal closure. Laryngeal closure was associated with increased work of breathing and respiratory neural drive preceded by an

  17. Contraindications to Athletic Participation. Cardiac, Respiratory, and Central Nervous System Conditions.

    Science.gov (United States)

    Moeller, James L.

    1996-01-01

    Discusses contraindications to athletic participation, examining the cardiac, respiratory, and central nervous system conditions that warrant activity disqualification. Provides guidelines about when it is safe for individuals to participate, and discusses the physician's responsibility. (SM)

  18. 33 CFR 142.39 - Respiratory protection.

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Respiratory protection. 142.39... Respiratory protection. (a) Personnel in an atmosphere specified under ANSI Z88.2, requiring the use of respiratory protection equipment shall wear the type of respiratory protection equipment specified in ANSI Z88...

  19. [Measurement of the passive compliance of the total respiratory system in newborn after respiratory insufficiency for risk assessment of respiratory disorders during the first 6 month of life].

    Science.gov (United States)

    Olechowski, Wiesław; Majorek-Olechowska, Bernadetta

    2010-01-01

    To evaluate the relationships between postnatal passive respiratory compliance (Crs) and development of respiratory disorders during the first 6 month of life in preterm and full-term infants after respiratory insufficiency. The purpose of this study was to investigate whether other relevant neonatal factors, like degree of prematurity, birth weigh, ventilatory conditions, sepsis, and respiratory disease severity affected this relationship. The passive respiratory compliance was measured by the single occlusion technique in 73 preterm infants after respiratory distress syndrome (RDS), 19 full-term infants after congenital pneumonia and 33 healthy full-term infants. Respiratory function measurements were performed by single occlusion technique, during natural sleep, after acute phase of illness, before discharge from neonatal department. Crs was significantly lower in premature newborns newborns who have suffered from a congenital pneumonia (p = 0.0411), than in healthy full-term newborn infants. Premature infants who have undergone sepsis have significantly decreased Crs in relationship with those who did not have this complication (p = 0.0334). Preterm newborns who have suffered pneumonia during treatment of RDS have significantly frequent respiratory problems during the first 6 month of age (p = 0.043). Full-term infants after congenital pneumonia have more but not significantly frequent respiratory problems than healthy term newborns (p = 0.055) in this period. Decreased neonatal Crs wasn't significantly related to respiratory disorders in age of 6 month of life. Prematurity under 36 week of gestational age, low birth weight and suffering from sepsis in premature infants significantly decreased Crs in newborn. Decreased neonatal Crs in premature and full term infants after respiratory insufficiency wasn't significantly related to respiratory disorders during first 6 month of life. This study has showed significantly increase of respiratory problems in this

  20. Comparative Effectiveness of Proactive Tobacco Treatment among Smokers with and without Chronic Lower Respiratory Disease.

    Science.gov (United States)

    Melzer, Anne C; Clothier, Barbara A; Japuntich, Sandra J; Noorbaloochi, Siamak; Hammett, Patrick; Burgess, Diana J; Joseph, Anne M; Fu, Steven S

    2018-03-01

    Adults with chronic lower respiratory disease differ in their barriers to smoking cessation but also suffer from tobacco-related health concerns, which may motivate quit attempts. Few studies have examined differences in tobacco treatment response between smokers with and without chronic lower respiratory disease. We examined the effectiveness of a proactive outreach program for cessation among smokers with and without chronic lower respiratory disease. Subgroup analysis of the Veterans Victory over Tobacco Study, a pragmatic randomized controlled trial that demonstrated the effectiveness of proactive outreach and the choice of tobacco treatments compared with usual care. Smokers identified via the electronic medical record were proactively offered phone-based counseling and care coordination to receive medication from their Veterans Affairs providers or in-person care. We compared the response among those with and without an International Classification of Diseases, 9th Revision diagnosis of a chronic lower respiratory disease (chronic obstructive pulmonary disease, chronic bronchitis, emphysema, asthma). We used stratification by propensity scores to adjust for imbalanced covariates between groups with and without chronic lower respiratory disease within each treatment arm, using complete case analysis accounting for the stratified sampling by site. The study participants were predominantly older, white, male smokers. Overall, 19.6% had chronic lower respiratory disease. A total of 3,307 had outcome data with the following assignments to the intervention: proactive care: n = 1,272 without chronic lower respiratory disease, n = 301 with chronic lower respiratory disease; usual care: n = 1,387 without chronic lower respiratory disease, n = 347 with chronic lower respiratory disease. A total of 1,888 had both complete baseline and outcome data and were included in the primary analysis. In unadjusted analyses (n = 3,307), among individuals with

  1. Antioxidant treatment with N-acetylcysteine during adult respiratory distress syndrome

    DEFF Research Database (Denmark)

    Jepsen, S; Herlevsen, P; Knudsen, P

    1992-01-01

    OBJECTIVE: To examine whether the antioxidant N-acetylcysteine could ameliorate the course of the adult respiratory distress syndrome (ARDS) in man. DESIGN: Randomized, double-blind, placebo-controlled study. SETTING: Medical and surgical ICU in a regional hospital. PATIENTS: Sixty-six ICU patients...

  2. Respiratory syncytial virus (RSV)

    Science.gov (United States)

    RSV; Palivizumab; Respiratory syncytial virus immune globulin; Bronchiolitis - RSV ... Crowe JE. Respiratory syncytial virus. In: Kliegman RM, Stanton BF, St. Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics . 20th ...

  3. Respiratory disease in relation to outdoor air pollution in Kanpur, India.

    Science.gov (United States)

    Liu, Hai-Ying; Bartonova, Alena; Schindler, Martin; Sharma, Mukesh; Behera, Sailesh N; Katiyar, Kamlesh; Dikshit, Onkar

    2013-01-01

    This paper examines the effect of outdoor air pollution on respiratory disease in Kanpur, India, based on data from 2006. Exposure to air pollution is represented by annual emissions of sulfur dioxide (SO(2)), particulate matter (PM), and nitrogen oxides (NO(x)) from 11 source categories, established as a geographic information system (GIS)-based emission inventory in 2 km × 2 km grid. Respiratory disease is represented by number of patients who visited specialist pulmonary hospital with symptoms of respiratory disease. The results showed that (1) the main sources of air pollution are industries, domestic fuel burning, and vehicles; (2) the emissions of PM per grid are strongly correlated to the emissions of SO(2) and NO(x); and (3) there is a strong correlation between visits to a hospital due to respiratory disease and emission strength in the area of residence. These results clearly indicate that appropriate health and environmental monitoring, actions to reduce emissions to air, and further studies that would allow assessing the development in health status are necessary.

  4. Modern features of infants’ feeding and its impact on respiratory diseases

    Directory of Open Access Journals (Sweden)

    Duka K.D.

    2015-03-01

    Full Text Available The article discusses the problem of infants’ feeding connected with the incidence of respiratory diseases. Rationality and duration of breast feeding does not cause doubts. But unfortunately today, only 60-80% of children under the age of 6 months are exclusively breastfed. Naturally, this causes impact on disease incidence of such children. Formation of bronchopulmonary pathology is of particular interest. The basis of modern research is the concept of programmed impact of nutrition in early childhood on health in lateryears. We have determined the dependence of respiratory diseases incidence in children of early age on duration of exclusively breast feeding. Not only frequent respiratory diseases, but formation of bronchitis, pneumonia or other complications of their course is of importance. The study included questioning of mothers and children under 7 years of age, clinical, radiological and laboratory investigations in the hospital in case of respiratory disease. All studies were conducted in accordance with the characteristics of diet quality of the child in the first year of life with the following biostatistical processing. 601 children aged from 3 months to 7 years were examined. It was found that the duration of breast feeding in the region is 89% only to the age of 6-months, and up to 1 year the percentage of breastfed children reduces to 38%. This affected the resistance of children to respiratory infections, especially in the first year of life. Children exclusively breastfed up to 1 year suffer from respiratory diseases 1-2 times per year. In children over one year of age breast feeding does not affect the frequency of respiratory pathology. Increase of respiratory diseases frequency in children aged 3-5 years is due to attending preschool institutions and increasing contacts between children, which significantly reduces their resistance.

  5. Radiologic findings of childhood lower respiratory tract infection by influenza virus

    Energy Technology Data Exchange (ETDEWEB)

    Song, Ho Taek; Park, Choong Ki; Shin, Hee Jung; Choi, Yo Won; Jeon, Seok Chol; Hahm, Chang Kok; Hern, Ahn You [Hanyang University College of Medicine, Seoul (Korea, Republic of)

    2002-08-01

    After the RS (respiratory syncytial) virus, the influenza virus is the most common cause of childhood lower respiratory tract infection. We assessed the radiologic findings of childhood lower respiratory tract infection by the influenza virus. A total of 105 pediatric patients (76 males and 29 females; mean age, 2.4 years) with symptoms of respiratory tract infection were examined between March 1997 and April 2000. Nasopharyngeal aspirates were obtained and influenza virus infection was confirmed by direct or indirect immunofluorescent assays. Peribronchial infiltration, hyperinflation, atelectasis, pulmonary consolidation, and hilar lymphadenopathy were evaluated retrospectively at simple chest radiography. Bilateral perihiler peribronchial infiltration was noted in 78.1% of patients (n=82), hyperinflation in 63.8% (n=67), atelectasis in 3.8% (n=4, segmental 50%, lobar 50%), and pulmonary consolidation in 16.2% [n=17; segmental 70.6% (n=12), lobar 29.4% (n=5)]. Hilar lymphadenopathy was noted in one patient in whom there was no pleural effusion, and subglottic airway narrowing in 12 of 14 in whom the croup symptom complex was present. The major radiologic findings of influenza virus infection were bilateral perihilar peribronchial infiltration and hyperinflation. In some patients, upper respiratory tract infection was combined with subgolttic airway narrowing. Atelectasis or pleural effusion was rare.

  6. Radiological features of lower respiratory infection by respiratory syncytial virus in infants and young children

    International Nuclear Information System (INIS)

    Kim, Woo Sun; Kim, In One; Yeon, Kyung Mo; Jang, Seong Hee; Lee, Hoan Jong

    1992-01-01

    Respiratory syncytial virus is the most common cause of lower respiratory infection (bronchiolitis and pneumonia) of infancy and early childhood. We analyzed clinical and radiological features of 76 patients with lower respiratory infections by respiratory syncytial virus, which were diagnosed by indirect immunofluorescent test or culture of nasal aspirate in Hep-2-cell monolayer, during the period of January- December, 1991. There were peaks of incidences in March-May and November- December, accounting for 87% of eases. Sixty-two cases (82%) were under 1 year of age. Fifty cases (66%) had underlying diseases. Major radiographical findings were overaeration (83%), parahilar peribronchial infiltrates (67%), segmental or subsegmental atelectasis (32%), and segmental or lobar consolidation (16%). In 15 cases (20%), overaeration was the only radiological findings. There was no evidence of pleural effusion or lymph node enlargement in all cases. By considering clinical features (symptoms, age, underlying diseases, epidemic seasons) in addition to the radiological findings, radiologists would be familiar with lower respiratory infection by respiratory syncytial virus. Air space consolidation, which is generally thought to represent bacterial pneumonia, is also observed not infrequently in respiratory syncytial virus infection

  7. Metagenomic analysis of viral diversity in respiratory samples from patients with respiratory tract infections in Kuwait.

    Science.gov (United States)

    Madi, Nada; Al-Nakib, Widad; Mustafa, Abu Salim; Habibi, Nazima

    2018-03-01

    A metagenomic approach based on target independent next-generation sequencing has become a known method for the detection of both known and novel viruses in clinical samples. This study aimed to use the metagenomic sequencing approach to characterize the viral diversity in respiratory samples from patients with respiratory tract infections. We have investigated 86 respiratory samples received from various hospitals in Kuwait between 2015 and 2016 for the diagnosis of respiratory tract infections. A metagenomic approach using the next-generation sequencer to characterize viruses was used. According to the metagenomic analysis, an average of 145, 019 reads were identified, and 2% of these reads were of viral origin. Also, metagenomic analysis of the viral sequences revealed many known respiratory viruses, which were detected in 30.2% of the clinical samples. Also, sequences of non-respiratory viruses were detected in 14% of the clinical samples, while sequences of non-human viruses were detected in 55.8% of the clinical samples. The average genome coverage of the viruses was 12% with the highest genome coverage of 99.2% for respiratory syncytial virus, and the lowest was 1% for torque teno midi virus 2. Our results showed 47.7% agreement between multiplex Real-Time PCR and metagenomics sequencing in the detection of respiratory viruses in the clinical samples. Though there are some difficulties in using this method to clinical samples such as specimen quality, these observations are indicative of the promising utility of the metagenomic sequencing approach for the identification of respiratory viruses in patients with respiratory tract infections. © 2017 Wiley Periodicals, Inc.

  8. Reliability of specific physical examination tests for the diagnosis of shoulder pathologies: a systematic review and meta-analysis.

    Science.gov (United States)

    Lange, Toni; Matthijs, Omer; Jain, Nitin B; Schmitt, Jochen; Lützner, Jörg; Kopkow, Christian

    2017-03-01

    Shoulder pain in the general population is common and to identify the aetiology of shoulder pain, history, motion and muscle testing, and physical examination tests are usually performed. The aim of this systematic review was to summarise and evaluate intrarater and inter-rater reliability of physical examination tests in the diagnosis of shoulder pathologies. A comprehensive systematic literature search was conducted using MEDLINE, EMBASE, Allied and Complementary Medicine Database (AMED) and Physiotherapy Evidence Database (PEDro) through 20 March 2015. Methodological quality was assessed using the Quality Appraisal of Reliability Studies (QAREL) tool by 2 independent reviewers. The search strategy revealed 3259 articles, of which 18 finally met the inclusion criteria. These studies evaluated the reliability of 62 test and test variations used for the specific physical examination tests for the diagnosis of shoulder pathologies. Methodological quality ranged from 2 to 7 positive criteria of the 11 items of the QAREL tool. This review identified a lack of high-quality studies evaluating inter-rater as well as intrarater reliability of specific physical examination tests for the diagnosis of shoulder pathologies. In addition, reliability measures differed between included studies hindering proper cross-study comparisons. PROSPERO CRD42014009018. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  9. Respiratory Issues in OI

    Science.gov (United States)

    Respiratory Issues in Osteogenesis Imperfecta \\ Introduction The respiratory system’s job is to bring oxygen into the body and remove carbon dioxide, the waste product of breathing. Because oxygen is the fuel ...

  10. Does Ultrasound-Enhanced Instruction of Musculoskeletal Anatomy Improve Physical Examination Skills of First-Year Medical Students?

    Science.gov (United States)

    Walrod, Bryant J; Schroeder, Allison; Conroy, Mark J; Boucher, Laura C; Bockbrader, Marcia; Way, David P; McCamey, Kendra L; Hartz, Clinton A; Jonesco, Michael A; Bahner, David P

    2018-01-01

    Ultrasound imaging is commonly used to teach basic anatomy to medical students. The purpose of this study was to determine whether learning musculoskeletal anatomy with ultrasound improved performance on medical students' musculoskeletal physical examination skills. Twenty-seven first-year medical students were randomly assigned to 1 of 2 instructional groups: either shoulder or knee. Both groups received a lecture followed by hands-on ultrasound scanning on live human models of the assigned joint. After instruction, students were assessed on their ability to accurately palpate 4 anatomic landmarks: the acromioclavicular joint, the proximal long-head biceps tendon, and the medial and lateral joint lines of the knee. Performance scores were based on both accuracy and time. A total physical examination performance score was derived for each joint. Scores for instructional groups were compared by a 2-way analysis of variance with 1 repeated measure. Significant findings were further analyzed with post hoc tests. All students performed significantly better on the knee examination, irrespective of instructional group (F = 14.9; df = 1.25; P = .001). Moreover, the shoulder instruction group performed significantly better than the knee group on the overall assessment (t = -3.0; df = 25; P soft tissue landmark. Both groups performed similarly on palpation of all other anatomic structures. The use of ultrasound appears to provide an educational advantage when learning musculoskeletal physical examination of soft tissue landmarks. © 2017 by the American Institute of Ultrasound in Medicine.

  11. Acute respiratory distress syndrome

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/000103.htm Acute respiratory distress syndrome To use the sharing features on this page, please enable JavaScript. Acute respiratory distress syndrome (ARDS) is a life-threatening lung ...

  12. Respiratory sinus arrhythmia responses to cognitive tasks : effects of task factors and RSA indices

    NARCIS (Netherlands)

    Overbeek, T.; Boxtel, van Anton; Westerink, J.H.D.M.

    2014-01-01

    Many studies show that respiratory sinus arrhythmia (RSA) decreases while performing cognitive tasks. However, there is uncertainty about the role of contaminating factors such as physical activity and stress-inducing task variables. Different methods to quantify RSA may also contribute to variable

  13. Respiratory sinus arrhythmia responses to cognitive tasks: Effects of task factors and RSA indices

    NARCIS (Netherlands)

    Overbeek, T.J.M.; van Boxtel, A.; Westerink, J.H.D.M.

    2014-01-01

    Many studies show that respiratory sinus arrhythmia (RSA) decreases while performing cognitive tasks. However, there is uncertainty about the role of contaminating factors such as physical activity and stress-inducing task variables. Different methods to quantify RSA may also contribute to variable

  14. Determinant Factors of Physical Fitness in European Children

    DEFF Research Database (Denmark)

    Zaqout, Mahmoud; Vyncke, Krishna; Moreno, Luis A.

    2016-01-01

    Objectives: This study was designed to explore the determinants of physical fitness in European children aged 6–11 years, cross-sectionally and longitudinally.Methods: There were sufficient data on 4903 children (50.6 % girls) on measured physical fitness (cardio-respiratory, muscular strength, f...

  15. Reliability of physical examination tests for the diagnosis of knee disorders: Evidence from a systematic review.

    Science.gov (United States)

    Décary, Simon; Ouellet, Philippe; Vendittoli, Pascal-André; Desmeules, François

    2016-12-01

    Clinicians often rely on physical examination tests to guide them in the diagnostic process of knee disorders. However, reliability of these tests is often overlooked and may influence the consistency of results and overall diagnostic validity. Therefore, the objective of this study was to systematically review evidence on the reliability of physical examination tests for the diagnosis of knee disorders. A structured literature search was conducted in databases up to January 2016. Included studies needed to report reliability measures of at least one physical test for any knee disorder. Methodological quality was evaluated using the QAREL checklist. A qualitative synthesis of the evidence was performed. Thirty-three studies were included with a mean QAREL score of 5.5 ± 0.5. Based on low to moderate quality evidence, the Thessaly test for meniscal injuries reached moderate inter-rater reliability (k = 0.54). Based on moderate to excellent quality evidence, the Lachman for anterior cruciate ligament injuries reached moderate to excellent inter-rater reliability (k = 0.42 to 0.81). Based on low to moderate quality evidence, the Tibiofemoral Crepitus, Joint Line and Patellofemoral Pain/Tenderness, Bony Enlargement and Joint Pain on Movement tests for knee osteoarthritis reached fair to excellent inter-rater reliability (k = 0.29 to 0.93). Based on low to moderate quality evidence, the Lateral Glide, Lateral Tilt, Lateral Pull and Quality of Movement tests for patellofemoral pain reached moderate to good inter-rater reliability (k = 0.49 to 0.73). Many physical tests appear to reach good inter-rater reliability, but this is based on low-quality and conflicting evidence. High-quality research is required to evaluate the reliability of knee physical examination tests. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. The pattern and technique in the clinical evaluation of the adult hip: the common physical examination tests of hip specialists.

    Science.gov (United States)

    Martin, Hal D; Kelly, Bryan T; Leunig, Michael; Philippon, Marc J; Clohisy, John C; Martin, RobRoy L; Sekiya, Jon K; Pietrobon, Ricardo; Mohtadi, Nicholas G; Sampson, Thomas G; Safran, Marc R

    2010-02-01

    The purpose of this study was to systematically evaluate the technique and tests used in the physical examination of the adult hip performed by multiple clinicians who regularly treat patients with hip problems and identify common physical examination patterns. The subjects included 5 men and 6 women with a mean age (+/-SD) of 29.8 +/- 9.4 years. They underwent physical examination of the hip by 6 hip specialists with a strong interest in hip-related problems. All examiners were blind to patient radiographs and diagnoses. Patient examinations were video recorded and reviewed. It was determined that 18 tests were most frequently performed (>or=40%) by the examiners, 3 standing, 11 supine, 3 lateral, and 1 prone. Of the most frequently performed tests, 10 were performed more than 50% of the time. The tests performed in the supine position were as follows: flexion range of motion (ROM) (percentage of use, 98%), flexion internal rotation ROM (98%), flexion external rotation ROM (86%), passive supine rotation test (76%), flexion/adduction/internal rotation test (70%), straight leg raise against resistance test (61%), and flexion/abduction/external rotation test (52%). The tests performed in the standing position were the gait test (86%) and the single-leg stance phase test (77%). The 1 test in the prone position was the femoral anteversion test (58%). There are variations in the testing that hip specialists perform to examine and evaluate their patients, but there is enough commonality to form the basis to recommend a battery of physical examination maneuvers that should be considered for use in evaluating the hip. Patients presenting with groin, abdominal, back, and/or hip pain need to have a basic examination to ensure that the hip is not overlooked. A comprehensive physical examination of the hip will benefit the patient and the physician and serve as the foundation for future multicenter clinical studies. (c) 2010 Arthroscopy Association of North America. Published

  17. Regional, age and respiratory-secretion-specific prevalence of respiratory viruses associated with asthma exacerbation: a literature review.

    Science.gov (United States)

    Zheng, Xue-Yan; Xu, Yan-Jun; Guan, Wei-Jie; Lin, Li-Feng

    2018-04-01

    Despite increased understanding of how viral infection is involved in asthma exacerbations, it is less clear which viruses are involved and to what extent they contribute to asthma exacerbations. Here, we sought to determine the prevalence of different respiratory viruses during asthma exacerbations. Systematic computerized searches of the literature up to June 2017 without language limitation were performed. The primary focus was on the prevalence of respiratory viruses, including AdV (adenovirus), BoV (bocavirus), CoV (coronavirus), CMV (cytomegalovirus), EnV (enterovirus), HSV (herpes simplex virus), IfV (influenza virus), MpV (metapneumovirus), PiV (parainfluenzavirus), RV (rhinovirus) and RSV (respiratory syncytial virus) during asthma exacerbations. We also examined the prevalence of viral infection stratified by age, geographic region, type of respiratory secretion, and detection method. Sixty articles were included in the final analysis. During asthma exacerbations, the mean prevalence of AdV, BoV, CoV, CMV, EnV, HSV, IfV, MpV, PiV, RV and RSV was 3.8%, 6.9%, 8.4%, 7.2%, 10.1%, 12.3%, 10.0%, 5.3%, 5.6%, 42.1% and 13.6%, respectively. EnV, MPV, RV and RSV were more prevalent in children, whereas AdV, BoV, CoV, IfV and PiV were more frequently present in adults. RV was the major virus detected globally, except in Africa. RV could be detected in both the upper and lower airway. Polymerase chain reaction was the most sensitive method for detecting viral infection. Our findings indicate the need to develop prophylactic polyvalent or polyvirus (including RV, EnV, IfV and RSV) vaccines that produce herd immunity and reduce the healthcare burden associated with virus-induced asthma exacerbations.

  18. Upper respiratory tract (image)

    Science.gov (United States)

    The major passages and structures of the upper respiratory tract include the nose or nostrils, nasal cavity, mouth, throat (pharynx), and voice box (larynx). The respiratory system is lined with a mucous membrane that ...

  19. Diagnostic Validity of Combining History Elements and Physical Examination Tests for Traumatic and Degenerative Symptomatic Meniscal Tears.

    Science.gov (United States)

    Décary, Simon; Fallaha, Michel; Frémont, Pierre; Martel-Pelletier, Johanne; Pelletier, Jean-Pierre; Feldman, Debbie E; Sylvestre, Marie-Pierre; Vendittoli, Pascal-André; Desmeules, François

    2017-10-27

    The current approach to the clinical diagnosis of traumatic and degenerative symptomatic meniscal tears (SMTs) proposes combining history elements and physical examination tests without systematic prescription of imaging investigations, yet the evidence to support this diagnostic approach is scarce. To assess the validity of diagnostic clusters combining history elements and physical examination tests to diagnose or exclude traumatic and degenerative SMT compared with other knee disorders. Prospective diagnostic accuracy study. Patients were recruited from 2 orthopedic clinics, 2 family medicine clinics, and from a university community. A total of 279 consecutive patients who underwent consultation for a new knee complaint. Each patient was assessed independently by 2 evaluators. History elements and standardized physical examination tests performed by a physiotherapist were compared with the reference standard: an expert physicians' composite diagnosis including a clinical examination and confirmatory magnetic resonance imaging. Participating expert physicians were orthopedic surgeons (n = 3) or sport medicine physicians (n = 2). Penalized logistic regression (least absolute shrinkage and selection operator) was used to identify history elements and physical examination tests associated with the diagnosis of SMT and recursive partitioning was used to develop diagnostic clusters. Diagnostic accuracy measures were calculated including sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios (LR+/-) with associated 95% confidence intervals (CIs). Eighty patients had a diagnosis of SMT (28.7%), including 35 traumatic tears and 45 degenerative tears. The combination a history of trauma during a pivot, medial knee pain location, and a positive medial joint line tenderness test was able to diagnose (LR+ = 8.9; 95% CI 6.1-13.1) or exclude (LR- = 0.10; 95% CI 0.03-0.28) a traumatic SMT. Combining a history of

  20. The peculiarities of food allergies in accordance with the level of injury of respiratory tract in children of Eastern Siberia

    Directory of Open Access Journals (Sweden)

    Irina V. Borisova

    2013-08-01

    Full Text Available Aim. To determine the course of food allergy in accordance with the level of respiratory tract injury in children of Eastern Siberia. Design of the research. We have examined 70 children aged 2–16, who have food sensibilization. We divided them into 2 groups: group I (n=32 with diseases of the upper and middle respiratory tract; and group II (n=38 with diseases of the lower respiratory tract. Methods. Allergological medical history, clinical laboratory examination and immunological examination, including the determination of IgA, IgM, IgG and IgE in blood serum. In cases where causal allergens were found, elimination diets were recommended. Results. Onset of upper respiratory tract injury in group I was more often registered in children aged 0–1; in group II, it was in the 3–7 age group. Isolated food sensibilization was more often marked in group I as compared to group II. Atopic mechanisms of respiratory tract injuries were more often registered in group II children. In the course of the elimination diet, we marked positive dynamics in 100% of group I and in 75% of group II. Conclusion. The most frequent allergens that cause respiratory forms of food allergy are hen eggs, cow milk, nutritive cereals, vegetables and fruit. Indices of a humoral link of immunity in the examined patients were more often registered as normal or their level is increased. Timely etiotropic therapy in the majority of cases allows for a stabilization of allergic inflammation.

  1. Respiratory cancer database: An open access database of respiratory cancer gene and miRNA.

    Science.gov (United States)

    Choubey, Jyotsna; Choudhari, Jyoti Kant; Patel, Ashish; Verma, Mukesh Kumar

    2017-01-01

    Respiratory cancer database (RespCanDB) is a genomic and proteomic database of cancer of respiratory organ. It also includes the information of medicinal plants used for the treatment of various respiratory cancers with structure of its active constituents as well as pharmacological and chemical information of drug associated with various respiratory cancers. Data in RespCanDB has been manually collected from published research article and from other databases. Data has been integrated using MySQL an object-relational database management system. MySQL manages all data in the back-end and provides commands to retrieve and store the data into the database. The web interface of database has been built in ASP. RespCanDB is expected to contribute to the understanding of scientific community regarding respiratory cancer biology as well as developments of new way of diagnosing and treating respiratory cancer. Currently, the database consist the oncogenomic information of lung cancer, laryngeal cancer, and nasopharyngeal cancer. Data for other cancers, such as oral and tracheal cancers, will be added in the near future. The URL of RespCanDB is http://ridb.subdic-bioinformatics-nitrr.in/.

  2. A Review on Human Respiratory Modeling.

    Science.gov (United States)

    Ghafarian, Pardis; Jamaati, Hamidreza; Hashemian, Seyed Mohammadreza

    2016-01-01

    Input impedance of the respiratory system is measured by forced oscillation technique (FOT). Multiple prior studies have attempted to match the electromechanical models of the respiratory system to impedance data. Since the mechanical behavior of airways and the respiratory system as a whole are similar to an electrical circuit in a combination of series and parallel formats some theories were introduced according to this issue. It should be noted that, the number of elements used in these models might be less than those required due to the complexity of the pulmonary-chest wall anatomy. Various respiratory models have been proposed based on this idea in order to demonstrate and assess the different parts of respiratory system related to children and adults data. With regard to our knowledge, some of famous respiratory models in related to obstructive, restrictive diseases and also Acute Respiratory Distress Syndrome (ARDS) are reviewed in this article.

  3. Diagnostic validity of physical examination tests for common knee disorders: An overview of systematic reviews and meta-analysis.

    Science.gov (United States)

    Décary, Simon; Ouellet, Philippe; Vendittoli, Pascal-André; Roy, Jean-Sébastien; Desmeules, François

    2017-01-01

    More evidence on diagnostic validity of physical examination tests for knee disorders is needed to lower frequently used and costly imaging tests. To conduct a systematic review of systematic reviews (SR) and meta-analyses (MA) evaluating the diagnostic validity of physical examination tests for knee disorders. A structured literature search was conducted in five databases until January 2016. Methodological quality was assessed using the AMSTAR. Seventeen reviews were included with mean AMSTAR score of 5.5 ± 2.3. Based on six SR, only the Lachman test for ACL injuries is diagnostically valid when individually performed (Likelihood ratio (LR+):10.2, LR-:0.2). Based on two SR, the Ottawa Knee Rule is a valid screening tool for knee fractures (LR-:0.05). Based on one SR, the EULAR criteria had a post-test probability of 99% for the diagnosis of knee osteoarthritis. Based on two SR, a complete physical examination performed by a trained health provider was found to be diagnostically valid for ACL, PCL and meniscal injuries as well as for cartilage lesions. When individually performed, common physical tests are rarely able to rule in or rule out a specific knee disorder, except the Lachman for ACL injuries. There is low-quality evidence concerning the validity of combining history elements and physical tests. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. Role of the dosed walking in the physical rehabilitation of children with bronchial asthma

    Directory of Open Access Journals (Sweden)

    Gagara V.F.

    2012-08-01

    Full Text Available The results of research of influence on the respiratory system of children are presented with bronchial asthma of complex of methods of physical rehabilitation. In research 20 children took part 10-11 years. To put got the complex of rehabilitation measures, which included medical physical education. The complex of respiratory gymnastics was directed on the improvement of functioning of the respiratory system, improvement of function of the external breathing, increase of excursion of thorax and strengthening of respiratory muscles. Exercises of this complex were executed children in a slow rate with an accent on control of breathing during implementation of exercises. Additionally conducted engaged in the dosed walking and the special dynamic respiratory exercises were executed on the method of Tolkachev. The indexes of the functional state of the respiratory system of children are appraised. It is set that for patients the indexes of excursion of thorax were increased, vital capacity of lights, forced vital capacity of lights, volume of the forced exhalation for the first second, by volume speed of spades, index of Tifno.

  5. Diagnostic and prognostic value of history-taking and physical examination in undifferentiated peripheral inflammatory arthritis: a systematic review.

    Science.gov (United States)

    Kuriya, Bindee; Villeneuve, Edith; Bombardier, Claire

    2011-03-01

    To review the diagnostic and prognostic value of history/physical examination among patients with undifferentiated peripheral inflammatory arthritis (UPIA). We conducted a systematic review evaluating the association between history/physical examination features and a diagnostic or prognostic outcome. Nineteen publications were included. Advanced age, female sex, and morning stiffness were predictive of a diagnosis of rheumatoid arthritis (RA) from UPIA. A higher number of tender and swollen joints, small/large joint involvement in the upper/lower extremities, and symmetrical involvement were associated with progression to RA. Similar features were associated with persistent disease and erosions, while disability at baseline and extraarticular features were predictive of future disability. History/physical examination features are heterogeneously reported. Several features predict progression from UPIA to RA or a poor prognosis. Continued measurements in the UPIA population are needed to determine if these features are valid and reliable predictors of outcomes, especially as new definitions for RA and disease states emerge.

  6. Determination of respiratory virus by RT-PCR in people with acute respiratory infection of the Area de Salud Pavas, Area de Salud Paraiso and Hospital Nacional de Ninos 'Dr. Carlos Saenz Herrera', in the period January 2012 to September 2012

    International Nuclear Information System (INIS)

    Montero Bonilla, Andrei

    2014-01-01

    Respiratory viruses are diagnosed through reverse transcriptase polymerase chain reaction (RT-PCR) in people with acute respiratory disease of the Area de Salud Pavas, Area de Salud Paraiso and Hospital Nacional de Ninos. The frequency of respiratory viruses are determined in the samples analyzed in the study population. The presence of viral coinfections is identified in the samples analyzed. The frequency of patients with respiratory viruses is categorized according to age in the study population. The frequency of respiratory viruses is examined between the studied geographic regions (Pavas and Paraiso). The results found by RT-PCR are compared with the frequency data reported with the direct immunofluorescence technique [es

  7. Avian respiratory system disorders

    Science.gov (United States)

    Olsen, Glenn H.

    1989-01-01

    Diagnosing and treating respiratory diseases in avian species requires a basic knowledge about the anatomy and physiology of this system in birds. Differences between mammalian and avian respiratory system function, diagnosis, and treatment are highlighted.

  8. Focused ultrasound examination of the chest on patients admitted with acute signs of respiratory problems

    DEFF Research Database (Denmark)

    Riishede, M; Laursen, C B; Teglbjærg, L S

    2016-01-01

    . As standard for correct diagnosis, we perform a blinded journal audit after discharge. As primary analysis, we use the intention-to-treat analysis. CONCLUSIONS: This study is the first multicentre trial in EDs to investigate whether f-US, in the hands of the EP, increases the proportion of correct diagnosis...... at 4 hours after arrival when performed on patients with respiratory problems. ETHICS AND DISSEMINATION: This trial is conducted in accordance with the Helsinki II Declaration and approved by the Danish Data Protection Agency and the Committee on Biomedical Research Ethics for the Region of Southern...

  9. Examining Physical and Sexual Abuse Histories as Correlates of Suicide Risk Among Firefighters.

    Science.gov (United States)

    Hom, Melanie A; Matheny, Natalie L; Stanley, Ian H; Rogers, Megan L; Cougle, Jesse R; Joiner, Thomas E

    2017-12-01

    Research indicates that physical and sexual abuse are associated with increased suicide risk; however, these associations have not been investigated among firefighters-an occupational group that has been shown to be at elevated suicide risk. This study examined whether physical and sexual abuse histories are associated with (a) career suicide ideation, plans, and attempts; and (b) current suicide risk (controlling for theoretically relevant symptoms) in this occupational group. A sample of 929 U.S. firefighters completed self-report surveys that assessed lifetime history of physical and sexual abuse; career suicide ideation, plans, and attempts; current suicide risk; and theoretically relevant symptoms. Logistic regression analyses revealed that individuals who reported a history of physical abuse were significantly more likely to report career suicide ideation, adjusted odds ratio [AOR] = 6.12, plans, AOR = 13.05, and attempts, AOR = 23.81, than those who did not. A similar pattern of findings emerged for individuals who reported a sexual abuse history, AORs = 7.83, 18.35, and 29.58 respectively. Linear regression analyses revealed that physical and sexual abuse histories each significantly predicted current suicide risk, even after controlling for theoretically relevant symptoms and demographics, pr 2 = .07 and .06, respectively. Firefighters with a history of physical and/or sexual abuse may be at increased risk for suicidal thoughts and behaviors. A history of physical and sexual abuse were each significantly correlated with current suicide risk in this population, even after accounting for the effects of theoretically relevant symptoms. Thus, when conceptualizing suicide risk among firefighters, factors not necessarily related to one's firefighter career should be considered. Copyright © 2017 International Society for Traumatic Stress Studies.

  10. Captured on Film: A Critical Examination of Representations of Physical Education at the Movies

    Science.gov (United States)

    Walton-Fisette, Jennifer L.; Walton-Fisette, Theresa A.; Chase, Laura Frances

    2017-01-01

    Background: Throughout this mediated society, young people, in particular, are mass consumers of corporatized media. The mediation of sport has long been critically examined within sociology and physical cultural studies [(e.g. Mcdonald, M. G., and S. Birrell. 1999. "Reading Sport Critically: A Methodology for Interrogating Power."…

  11. Respiratory muscle strength of patients with esophagus and stomach neoplasms

    Directory of Open Access Journals (Sweden)

    Evelyn Aline Boscolo Ruivo

    Full Text Available Abstract Introduction: In cancer patients, the reduced food intake causes weight loss and promotes protein-calorie malnutrition. This results in loss of lean body mass, which affects both skeletal muscles and respiratory muscles. Objective: Evaluate and compare the respiratory muscle strength of patients with esophageal and stomach neoplasia during the preoperative period. Methods: This is a cross-sectional study carried out with 24 patients of both genders hospitalized in a teaching hospital. They underwent a physical therapy evaluation composed of anthropometric data and measurement of respiratory muscle strength through manovacuometry. Paired and unpaired t-tests were used to compare the values obtained with the predicted equations. Results: Regarding the disease prevalence, 66.66%(16 of the individuals had stomach neoplasm and 33.33%(8 esophageal neoplasm. Of the patients with esophageal neoplasm, 100% were men with a mean age of 63 ± 9.16 years. Of those with stomach neoplasm, 68.75% were men with a mean age of 69.36 ± 10.92 years. Female patients with stomach neoplasm had significantly higher BMI (p = 0.01 than male patients, and they were classified as overweight. Both neoplasms had significantly lower real values (p ≤ 0.05 than predicted values at the maximal expiratory pressure. Conclusion: Patients with esophageal and stomach neoplasms in the preoperative period present reduction in the expiratory muscle strength. There were no statistically significant differences, when we compared the maximum respiratory pressures between the two types of neoplasms investigated.

  12. The use of a pocket-sized ultrasound device improves physical examination: results of an in- and outpatient cohort study.

    Directory of Open Access Journals (Sweden)

    Agostino Colli

    Full Text Available The performance of pocket mobile ultrasound devices (PUDs is comparable with that of standard ultrasonography, whereas the accuracy of a physical examination is often poor requiring further tests to assess diagnostic hypotheses. Adding the use of PUD to physical examination could lead to an incremental benefit.We assessed whether the use of PUD in the context of physical examination can reduce the prescription of additional tests when used by physicians in different clinical settings.We conducted a cohort impact study in four hospital medical wards, one gastroenterological outpatient clinic, and 90 general practices in the same geographical area. The study involved 135 physicians who used PUD, after a short predefined training course, to examine 1962 consecutive patients with one of 10 diagnostic hypotheses: ascites, pleural effusion, pericardial effusion, urinary retention, urinary stones, gallstones, biliary-duct dilation, splenomegaly, abdominal mass, abdominal aortic aneurysm. According to the physicians' judgment, PUD examination could rule out or in the diagnostic hypothesis or require further testing; the concordance with the final diagnosis was assessed. The main outcome was the proportion of cases in which additional tests were required after PUD. The PUD diagnostic accuracy was assessed in patients submitted to further testing.The 1962 patients included 37% in-patients, 26% gastroenterology outpatients, 37% from general practices. Further testing after PUD examination was deemed unnecessary in 63%. Only 5% of patients with negative PUD not referred for further testing were classified false negatives with respect to the final diagnosis. In patients undergoing further tests, the sensitivity was 91%, and the specificity 83%.After a simple and short training course, a PUD examination can be used in addition to a physical examination to improve the answer to ten common clinical questions concerning in- and outpatients, and can reduce the

  13. Management of respiratory symptoms in ALS.

    LENUS (Irish Health Repository)

    Hardiman, Orla

    2012-02-01

    Respiratory insufficiency is a frequent feature of ALS and is present in almost all cases at some stage of the illness. It is the commonest cause of death in ALS. FVC is used as important endpoint in many clinical trials, and in decision-making events for patients with ALS, although there are limitations to its predictive utility. There are multiple causes of respiratory muscle failure, all of which act to produce a progressive decline in pulmonary function. Diaphragmatic fatigue and weakness, coupled with respiratory muscle weakness, lead to reduced lung compliance and atelectasis. Increased secretions increase the risk of aspiration pneumonia, which further compromises respiratory function. Bulbar dysfunction can lead to nutritional deficiency, which in turn increases the fatigue of respiratory muscles. Early recognition of respiratory decline and symptomatic intervention, including non-invasive ventilation can significantly enhance both quality of life and life expectancy in ALS. Patients with respiratory failure should be advised to consider an advance directive to avoid emergency mechanical ventilation.

  14. Management of respiratory symptoms in ALS.

    LENUS (Irish Health Repository)

    Hardiman, Orla

    2011-03-01

    Respiratory insufficiency is a frequent feature of ALS and is present in almost all cases at some stage of the illness. It is the commonest cause of death in ALS. FVC is used as important endpoint in many clinical trials, and in decision-making events for patients with ALS, although there are limitations to its predictive utility. There are multiple causes of respiratory muscle failure, all of which act to produce a progressive decline in pulmonary function. Diaphragmatic fatigue and weakness, coupled with respiratory muscle weakness, lead to reduced lung compliance and atelectasis. Increased secretions increase the risk of aspiration pneumonia, which further compromises respiratory function. Bulbar dysfunction can lead to nutritional deficiency, which in turn increases the fatigue of respiratory muscles. Early recognition of respiratory decline and symptomatic intervention, including non-invasive ventilation can significantly enhance both quality of life and life expectancy in ALS. Patients with respiratory failure should be advised to consider an advance directive to avoid emergency mechanical ventilation.

  15. Management of Postoperative Respiratory Failure.

    Science.gov (United States)

    Mulligan, Michael S; Berfield, Kathleen S; Abbaszadeh, Ryan V

    2015-11-01

    Despite best efforts, postoperative complications such as postoperative respiratory failure may occur and prompt recognition of the process and management is required. Postoperative respiratory failure, such as postoperative pneumonia, postpneumonectomy pulmonary edema, acute respiratory distress-like syndromes, and pulmonary embolism, are associated with high morbidity and mortality. The causes of these complications are multifactorial and depend on preoperative, intraoperative, and postoperative factors, some of which are modifiable. The article identifies some of the risk factors, causes, and treatment strategies for successful management of the patient with postoperative respiratory failure. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Respiratory monitoring with an acceleration sensor

    International Nuclear Information System (INIS)

    Ono, Tomohiro; Takegawa, Hideki; Ageishi, Tatsuya; Takashina, Masaaki; Numasaki, Hodaka; Matsumoto, Masao; Teshima, Teruki

    2011-01-01

    Respiratory gating radiotherapy is used to irradiate a local area and to reduce normal tissue toxicity. There are certain methods for the detection of tumor motions, for example, using internal markers or an external respiration signal. However, because some of these respiratory monitoring systems require special or expensive equipment, respiratory monitoring can usually be performed only in limited facilities. In this study, the feasibility of using an acceleration sensor for respiratory monitoring was evaluated. The respiratory motion was represented by means of a platform and measured five times with the iPod touch (registered) at 3, 4 and 5 s periods of five breathing cycles. For these three periods of the reference waveform, the absolute means ± standard deviation (SD) of displacement were 0.45 ± 0.34 mm, 0.33 ± 0.24 mm and 0.31 ± 0.23 mm, respectively. On the other hand, the corresponding absolute means ± SD for the periods were 0.04 ± 0.09 s, 0.04 ± 0.02 s and 0.06 ± 0.04 s. The accuracy of respiratory monitoring using the acceleration sensor was satisfactory in terms of the absolute means ± SD. Using the iPod touch (registered) for respiratory monitoring does not need special equipment and makes respiratory monitoring easier. For these reasons, this system is a viable alternative to other respiratory monitoring systems.

  17. Quantitation of respiratory viruses in relation to clinical course in children with acute respiratory tract infections

    NARCIS (Netherlands)

    Jansen, Rogier R.; Schinkel, Janke; dek, Irene; Koekkoek, Sylvie M.; Visser, Caroline E.; de Jong, Menno D.; Molenkamp, Richard; Pajkrt, Dasja

    2010-01-01

    Quantitation of respiratory viruses by PCR could potentially aid in clinical interpretation of PCR results. We conducted a study in children admitted with acute respiratory tract infections to study correlations between the clinical course of illness and semiquantitative detection of 14 respiratory

  18. Long-term physical activity in leisure time and mortality from coronary heart disease, stroke, respiratory diseases, and cancer. The Copenhagen City Heart Study

    DEFF Research Database (Denmark)

    Schnohr, Peter; Lange, Peter; Scharling, Henrik

    2006-01-01

    BACKGROUND: The purpose of this study was to describe the associations between different levels of long-term physical activity in leisure time and subsequent causes of deaths. DESIGN: The Copenhagen City Heart Study is a prospective cardiovascular population study of 19 329 men and women aged 20......-93 in 1976. Physical activity in leisure time was estimated at the examinations in 1976-78 and 1981-83. This analysis consists of 2136 healthy men and 2758 women aged 20-79 years, with unchanged physical activity at the two examinations, and with all covariates included in the multivariate analyses: smoking...... gained years of expected lifetime from age 50. Men with high physical activity survived 6.8 years longer, and men with moderate physical activity 4.9 years longer than sedentary men. For women the figures were 6.4 and 5.5 years, respectively. CONCLUSION: Long-term moderate or high physical activity...

  19. Respiratory innate immune proteins differentially modulate the neutrophil respiratory burst response to influenza A virus

    DEFF Research Database (Denmark)

    White, Mitchell R; Crouch, Erika; Vesona, Jenny

    2005-01-01

    of IAV with SP-D in vitro strongly increases neutrophil respiratory burst responses to the virus. Several factors are shown to modify this apparent proinflammatory effect of SP-D. Although multimeric forms of SP-D show dose-dependent augmentation of respiratory burst responses, trimeric, single-arm forms...... of IAV while reducing the respiratory burst response to virus....

  20. Cardiovascular and respiratory hospitalizations and mortality among users of tiotropium in Denmark

    DEFF Research Database (Denmark)

    de Luise, Cynthia; Lanes, Stephan F; Jacobsen, Jacob

    2007-01-01

    .17). Compared to periods of non-use, tiotropium was associated with reduced respiratory and overall mortality and was not associated with increased cardiac mortality. An increase in COPD hospitalization is inconsistent with clinical trial data and suggests preferential prescribing due to disease severity.......Tiotropium (Spiriva is an inhaled, once-daily anticholinergic medication for chronic obstructive pulmonary disease (COPD). We conducted a population-based cohort study to examine the risk of cardiovascular and respiratory hospitalizations and mortality with tiotropium. Using the Danish healthcare...... registries, we identified persons >/=40 years old in three counties who were hospitalized for COPD from 1/1/1977 to 12/31/2003. Respiratory and cardiovascular medications were assessed from dispensing records. Cox regression was used to compute incidence rate ratios (RR) and 95% confidence intervals (CI...

  1. Respiratory health effects associated with restoration work in post-Hurricane Katrina New Orleans.

    Science.gov (United States)

    Rando, Roy J; Lefante, John J; Freyder, Laurie M; Jones, Robert N

    2012-01-01

    This study examines prevalence of respiratory conditions in New Orleans-area restoration workers after Hurricane Katrina. Between 2007 and 2010, spirometry and respiratory health and occupational questionnaire were administered to 791 New Orleans-area adults who mostly worked in the building construction and maintenance trades or custodial services. The associations between restoration work hours and lung function and prevalence of respiratory symptoms were examined by multiple linear regression, χ², or multiple logistic regression. 74% of participants performed post-Katrina restoration work (median time: 620 hours). Symptoms reported include episodes of transient fever/cough (29%), sinus symptoms (48%), pneumonia (3.7%), and new onset asthma (4.5%). Prevalence rate ratios for post-Katrina sinus symptoms (PRR = 1.3; CI: 1.1, 1.7) and fever and cough (PRR = 1.7; CI: 1.3, 2.4) were significantly elevated overall for those who did restoration work and prevalence increased with restoration work hours. Prevalence rate ratios with restoration work were also elevated for new onset asthma (PRR = 2.2; CI: 0.8, 6.2) and pneumonia (PRR = 1.3; CI: 0.5, 3.2) but were not statistically significant. Overall, lung function was slightly depressed but was not significantly different between those with and without restoration work exposure. Post-Katrina restoration work is associated with moderate adverse effects on respiratory health, including sinusitis and toxic pneumonitis.

  2. The "Near-Peer" Approach to Teaching Musculoskeletal Physical Examination Skills Benefits Residents and Medical Students.

    Science.gov (United States)

    Rosenberg, Casandra J; Nanos, Katherine N; Newcomer, Karen L

    2017-03-01

    The musculoskeletal physical examination (MSK PE) is an essential part of medical student training, and it is best taught in a hands-on, longitudinal fashion. A barrier to this approach is faculty instructor availability. "Near-peer" teaching refers to physicians-in-training teaching their junior colleagues. It is unknown whether near-peer teaching is effective in teaching this important physical examination skill. To investigate attitudes of medical students and physical medicine and rehabilitation (PM&R) residents regarding near-peer teaching in an MSK PE curriculum. Qualitative, anonymous paper and online surveys. Tertiary academic center with a medical school and PM&R training program. Ninety-nine second- and third-year medical students and 13 PM&R residents in their third or fourth postgraduate year. Attitudes of second- and third-year medical students were measured immediately after their MSK PE course. Resident attitudes were measured in a single cross-sectional sample. Student attitudes were assessed via a questionnaire with 5-point Likert scales and a free-text comment section. The resident questionnaire included a combination of multiple-choice questions, rankings, free-text responses, and Likert scales. All 99 students completed the questionnaire. The majority of students (n = 79 [80%]) reported that resident involvement as hands-on instructors of examination skills was "very useful," and 87 (88%) indicated that resident-led small discussion groups were "very helpful" or "somewhat helpful." Fifty-seven of 99 students (58%) reported that the resident-facilitated course was "much better" than courses without resident involvement. Twelve of 13 eligible residents completed the survey, and of those, 8 found teaching "very helpful" to their MSK knowledge, and 11 became "somewhat" or "much more confident" in clinical examination skills. Our study supports educational benefits to medical students and resident instructors in our MSK PE program. We recommend

  3. Effects of respiratory muscle work on respiratory and locomotor blood flow during exercise.

    Science.gov (United States)

    Dominelli, Paolo B; Archiza, Bruno; Ramsook, Andrew H; Mitchell, Reid A; Peters, Carli M; Molgat-Seon, Yannick; Henderson, William R; Koehle, Michael S; Boushel, Robert; Sheel, A William

    2017-11-01

    What is the central question of this study? Does manipulation of the work of breathing during high-intensity exercise alter respiratory and locomotor muscle blood flow? What is the main finding and its importance? We found that when the work of breathing was reduced during exercise, respiratory muscle blood flow decreased, while locomotor muscle blood flow increased. Conversely, when the work of breathing was increased, respiratory muscle blood flow increased, while locomotor muscle blood flow decreased. Our findings support the theory of a competitive relationship between locomotor and respiratory muscles during intense exercise. Manipulation of the work of breathing (WOB) during near-maximal exercise influences leg blood flow, but the effects on respiratory muscle blood flow are equivocal. We sought to assess leg and respiratory muscle blood flow simultaneously during intense exercise while manipulating WOB. Our hypotheses were as follows: (i) increasing the WOB would increase respiratory muscle blood flow and decrease leg blood flow; and (ii) decreasing the WOB would decrease respiratory muscle blood flow and increase leg blood flow. Eight healthy subjects (n = 5 men, n = 3 women) performed a maximal cycle test (day 1) and a series of constant-load exercise trials at 90% of peak work rate (day 2). On day 2, WOB was assessed with oesophageal balloon catheters and was increased (via resistors), decreased (via proportional assist ventilation) or unchanged (control) during the trials. Blood flow was assessed using near-infrared spectroscopy optodes placed over quadriceps and the sternocleidomastoid muscles, coupled with a venous Indocyanine Green dye injection. Changes in WOB were significantly and positively related to changes in respiratory muscle blood flow (r = 0.73), whereby increasing the WOB increased blood flow. Conversely, changes in WOB were significantly and inversely related to changes in locomotor blood flow (r = 0.57), whereby decreasing the

  4. Recurrent Respiratory Papillomatosis or Laryngeal Papillomatosis

    Science.gov (United States)

    ... Home » Health Info » Voice, Speech, and Language Recurrent Respiratory Papillomatosis or Laryngeal Papillomatosis On this page: What ... find additional information about RRP? What is recurrent respiratory papillomatosis? Recurrent respiratory papillomatosis (RRP) is a disease ...

  5. Assessment of structured physical examination skills training using a retro-pre-questionnaire.

    Science.gov (United States)

    Piryani, Rano Mal; Shankar, P Ravi; Piryani, Suneel; Thapa, Trilok Pati; Karki, Balmansingh; Khakurel, Mahesh Prasad; Bhandary, Shital

    2013-01-01

    The effectiveness of physical examination skills (PES) training is very rarely assessed using the "post-then-pre" approach. In this study, a retro-pre-questionnaire was used to study the effect of structured physical examination skills training (SPEST) imparted to second-year undergraduate medical students. KIST Medical College (KISTMC) affiliated to Tribhuvan University Nepal admitted its first batch of MBBS students in November 2008. The university curriculum recommends the involvement of Medicine and Surgery Departments in PES training, but the methods for teaching and assessment are not well defined. KISTMC has made training more structured and involved the Medicine, Surgery, Gynaecology and Obstetrics, Orthopaedics, ENT, Ophthalmology, Paediatrics, and Family Medicine Departments. SPEST includes the teaching/learning of basic PES for 210 minutes once a week for 28 weeks. Self-assessment is done by using a retro-pre-questionnaire at the end of the last session of training, and these data are analysed using SPSS. Out of 100 students, 98 participated in the objective structured clinical examination (OSCE); 82 completed the retro-pre-questionnaire. Forty-six skills representing various systems were selected for inclusion in the retro-pre-questionnaire from among the many skills taught in different departments. The average perceived skills score (maximum score, 46×4=184) before training was 15.9 and increased to 116.5 after training. The increase was statistically significant upon the application of a paired t-test. The students perceived that their level of skills improved after the training. The retro-pre- instrument seems to be useful for assessing the learners' self-reported changes in PES after training if a large number of skills need to be assessed. However, it should be noted that although a retro-pre-questionnaire may reveal valuable information, it is not a substitute for an objective measure or gold standard.

  6. Increased vocal intensity due to the Lombard effect in speakers with Parkinson's disease: simultaneous laryngeal and respiratory strategies.

    Science.gov (United States)

    Stathopoulos, Elaine T; Huber, Jessica E; Richardson, Kelly; Kamphaus, Jennifer; DeCicco, Devan; Darling, Meghan; Fulcher, Katrina; Sussman, Joan E

    2014-01-01

    The objective of the present study was to investigate whether speakers with hypophonia, secondary to Parkinson's disease (PD), would increases their vocal intensity when speaking in a noisy environment (Lombard effect). The other objective was to examine the underlying laryngeal and respiratory strategies used to increase vocal intensity. Thirty-three participants with PD were included for study. Each participant was fitted with the SpeechVive™ device that played multi-talker babble noise into one ear during speech. Using acoustic, aerodynamic and respiratory kinematic techniques, the simultaneous laryngeal and respiratory mechanisms used to regulate vocal intensity were examined. Significant group results showed that most speakers with PD (26/33) were successful at increasing their vocal intensity when speaking in the condition of multi-talker babble noise. They were able to support their increased vocal intensity and subglottal pressure with combined strategies from both the laryngeal and respiratory mechanisms. Individual speaker analysis indicated that the particular laryngeal and respiratory interactions differed among speakers. The SpeechVive™ device elicited higher vocal intensities from patients with PD. Speakers used different combinations of laryngeal and respiratory physiologic mechanisms to increase vocal intensity, thus suggesting that disease process does not uniformly affect the speech subsystems. Readers will be able to: (1) identify speech characteristics of people with Parkinson's disease (PD), (2) identify typical respiratory strategies for increasing sound pressure level (SPL), (3) identify typical laryngeal strategies for increasing SPL, (4) define the Lombard effect. Copyright © 2014 Elsevier Inc. All rights reserved.

  7. Examining End-of-Chapter Problems across Editions of an Introductory Calculus-Based Physics Textbook

    Science.gov (United States)

    Xiao, Bin

    2016-01-01

    End-Of-Chapter (EOC) problems have been part of many physics education studies. Typically, only problems "localized" as relevant to a single chapter were used. This work examines how well this type of problem represents all EOC problems and whether EOC problems found in leading textbooks have changed over the past several decades. To…

  8. Perceived influence and college students' diet and physical activity behaviors: an examination of ego-centric social networks.

    Science.gov (United States)

    Harmon, Brook E; Forthofer, Melinda; Bantum, Erin O; Nigg, Claudio R

    2016-06-06

    Obesity is partially a social phenomenon, with college students particularly vulnerable to changes in social networks and obesity-related behaviors. Currently, little is known about the structure of social networks among college students and their potential influence on diet and physical activity behaviors. The purpose of the study was to examine social influences impacting college students' diet and physical activity behaviors, including sources of influence, comparisons between sources' and students' behaviors, and associations with meeting diet and physical activity recommendations. Data was collected from 40 students attending college in Hawaii. Participants completed diet and physical activity questionnaires and a name generator. Participants rated nominees' influence on their diet and physical activity behaviors as well as compared nominees' behaviors to their own. Descriptive statistics were used to look at perceptions of influence across network groups. Logistic regression models were used to examine associations between network variables and odds of meeting recommendations. A total of 325 nominations were made and included: family (n = 116), college friends (n = 104), high school friends (n = 87), and significant others (n = 18). Nearly half of participants were not from Hawaii. Significant others of non-Hawaii students were perceived to be the most influential (M(SD) = 9(1.07)) and high school friends the least influential (M(SD) = 1.31(.42)) network. Overall, perceived influence was highest for diet compared to physical activity, but varied based on comparisons with nominees' behaviors. Significant others were most often perceived has having similar (44 %) or worse (39 %) eating behaviors than participants, and those with similar eating behaviors were perceived as most influential (M(SD) = 9.25(1.04)). Few associations were seen between network variables and odds of meeting recommendations. Among the groups nominated, high

  9. Perceived influence and college students’ diet and physical activity behaviors: an examination of ego-centric social networks

    Directory of Open Access Journals (Sweden)

    Brook E. Harmon

    2016-06-01

    Full Text Available Abstract Background Obesity is partially a social phenomenon, with college students particularly vulnerable to changes in social networks and obesity-related behaviors. Currently, little is known about the structure of social networks among college students and their potential influence on diet and physical activity behaviors. The purpose of the study was to examine social influences impacting college students’ diet and physical activity behaviors, including sources of influence, comparisons between sources’ and students’ behaviors, and associations with meeting diet and physical activity recommendations. Methods Data was collected from 40 students attending college in Hawaii. Participants completed diet and physical activity questionnaires and a name generator. Participants rated nominees’ influence on their diet and physical activity behaviors as well as compared nominees' behaviors to their own. Descriptive statistics were used to look at perceptions of influence across network groups. Logistic regression models were used to examine associations between network variables and odds of meeting recommendations. Results A total of 325 nominations were made and included: family (n = 116, college friends (n = 104, high school friends (n = 87, and significant others (n = 18. Nearly half of participants were not from Hawaii. Significant others of non-Hawaii students were perceived to be the most influential (M(SD = 9(1.07 and high school friends the least influential (M(SD = 1.31(.42 network. Overall, perceived influence was highest for diet compared to physical activity, but varied based on comparisons with nominees’ behaviors. Significant others were most often perceived has having similar (44 % or worse (39 % eating behaviors than participants, and those with similar eating behaviors were perceived as most influential (M(SD = 9.25(1.04. Few associations were seen between network variables and odds of meeting

  10. A Novel Parametric Model For The Human Respiratory System

    Directory of Open Access Journals (Sweden)

    Clara Mihaela IONESCU

    2003-12-01

    Full Text Available The purpose of this work is to present some recent results in an ongoing research project between Ghent University and Chess Medical Technology Company Belgium. The overall aim of the project is to provide a fast method for identification of the human respiratory system in order to allow for an instantaneously diagnosis of the patient by the medical staff. A novel parametric model of the human respiratory system as well as the obtained experimental results is presented in this paper. A prototype apparatus developed by the company, based on the forced oscillation technique is used to record experimental data from 4 patients in this paper. Signal processing is based on spectral analysis and is followed by the parametric identification of a non-linear mechanistic model. The parametric model is equivalent to the structure of a simple electrical RLC-circuit, containing a non-linear capacitor. These parameters have a useful and easy-to-interpret physical meaning for the medical staff members.

  11. Inactivity-induced respiratory plasticity: Protecting the drive to breathe in disorders that reduce respiratory neural activity☆

    Science.gov (United States)

    Strey, K.A.; Baertsch, N.A.; Baker-Herman, T.L.

    2013-01-01

    Multiple forms of plasticity are activated following reduced respiratory neural activity. For example, in ventilated rats, a central neural apnea elicits a rebound increase in phrenic and hypoglossal burst amplitude upon resumption of respiratory neural activity, forms of plasticity called inactivity-induced phrenic and hypoglossal motor facilitation (iPMF and iHMF), respectively. Here, we provide a conceptual framework for plasticity following reduced respiratory neural activity to guide future investigations. We review mechanisms giving rise to iPMF and iHMF, present new data suggesting that inactivity-induced plasticity is observed in inspiratory intercostals (iIMF) and point out gaps in our knowledge. We then survey conditions relevant to human health characterized by reduced respiratory neural activity and discuss evidence that inactivity-induced plasticity is elicited during these conditions. Understanding the physiological impact and circumstances in which inactivity-induced respiratory plasticity is elicited may yield novel insights into the treatment of disorders characterized by reductions in respiratory neural activity. PMID:23816599

  12. Association between air pollution and general practitioner visits for respiratory diseases in Hong Kong

    OpenAIRE

    Wong, TW; Tam, W; Wun, YT; Wong, CM; Yu, ITS; Wong, AHS

    2006-01-01

    Background: Few studies have explored the relation between air pollution and general practitioner (GP) consultations in Asia. Clinic attendance data from a network of GPs were studied, and the relationship between daily GP consultations for upper respiratory tract infections (URTI) and non-URTI respiratory diseases and daily air pollutant concentrations measured in their respective districts was examined. Methods: A time series study was performed in 2000-2002 using data on daily patient cons...

  13. Effects of air pollution on general practitioner consultations for upper respiratory diseases in London

    OpenAIRE

    Hajat, S; Anderson, H; Atkinson, R; Haines, A; Seaton, A.

    2002-01-01

    Objectives: Few published studies have examined the effect of air pollution on upper respiratory conditions. Furthermore, most epidemiological studies on air pollution focus on mortality or hospital admissions as the main health outcomes, but very rarely consider the effect in primary care. If pollution effects do exist then the public health impact could be considerable because of the many patient contacts involved. We investigated the relation between air pollution and upper respiratory dis...

  14. Utility of AD8 for Cognitive Impairment in a Chinese Physical Examination Population: A Preliminary Study

    Directory of Open Access Journals (Sweden)

    Yue Xie

    2014-01-01

    Full Text Available Objective. To investigate the utility of AD8 for cognitive impairment in a Chinese physical examination population. Methods. Military cadres who took routine physical examination in Chinese PLA General Hospital from Jan 1, 2013, to Dec 31, 2013, were subjected to AD8 scale. Individual information such as age, gender, and education was also collected. All data were analyzed by SPSS 19.0. Results. 1544 subjects were enrolled in this study with mean age 75.4 ± 10.6 years. The subjects who scored 0 to 8 of AD8 scale were 1015, 269, 120, 60, 30, 14, 19, 8, and 9, respectively. Corresponding proportions were 65.7%, 17.4%, 7.8%, 3.9%, 2.0%, 0.9%, 1.2%, 0.5%, and 0.6%, respectively. The endorsement prevalence of 8 questions was 5.6%, 9.2%, 6.6%, 9.2%, 4.8%, 4.5%, 8.9%, and 24.1%, respectively. The endorsement prevalence of question 8 was significantly higher than others (P<0.05. 260 subjects were scored equal to or greater than 2. The abnormal rate was 16.9%. All the participants were stratified into 9 groups by age; the prevalence of dementia was highly correlated with age (P<0.01. Conclusion. AD8 scale is a convenient and effective tool for cognitive screening in routine physical examination population.

  15. Clinical examination and physical assessment of hip joint-related pain in athletes

    DEFF Research Database (Denmark)

    Reiman, Michael P; Thorborg, Kristian

    2014-01-01

    UNLABELLED: Evidence-based clinical examination and assessment of the athlete with hip joint related pain is complex. It requires a systematic approach to properly differentially diagnose competing potential causes of athletic pain generation. An approach with an initial broad focus (and hence use...... of highly sensitive tests/measures) that then is followed by utilizing more specific tests/measures to pare down this imprecise differential diagnosis list is suggested. Physical assessment measures are then suggested to discern impairments, activity and participation restrictions for athletes with hip...

  16. Household reporting of childhood respiratory health and air pollution in rural Alaska Native communities

    Directory of Open Access Journals (Sweden)

    Desirae N. Ware

    2014-05-01

    Full Text Available Background: Air pollution is an important contributor to respiratory disease in children. Objective: To examine associations between household reporting of childhood respiratory conditions and household characteristics related to air pollution in Alaska Native communities. Design: In-home surveys were administered in 2 rural regions of Alaska. The 12-month prevalence of respiratory conditions was summarized by region and age. Odds ratios (ORs were calculated to describe associations between respiratory health and household and air quality characteristics. Results: Household-reported respiratory health data were collected for 561 children in 328 households. In 1 region, 33.6% of children aged <5 years had a recent history of pneumonia and/or bronchitis. Children with these conditions were 2 times more likely to live in a wood-heated home, but these findings were imprecise. Resident concern with mould was associated with elevated prevalence of respiratory infections in children (ORs 1.6–2.5, while reported wheezing was associated with 1 or more smokers living in the household. Reported asthma in 1 region (7.6% was lower than national prevalence estimates. Conclusions: Findings suggest that there may be preventable exposures, including wood smoke and mould that affect childhood respiratory disease in these rural areas. Additional research is needed to quantify particulate matter 2.5 microns in aerodynamic diameter or less and mould exposures in these communities, and to objectively evaluate childhood respiratory health.

  17. Preoperative physical examination and imaging of femoroacetabular impingement prior to hip arthroscopy-a systematic review.

    Science.gov (United States)

    Haldane, Chloe E; Ekhtiari, Seper; de Sa, Darren; Simunovic, Nicole; Ayeni, Olufemi R

    2017-08-01

    The purpose of this systematic review is to report current preoperative assessment for femoroacetabular impingement (FAI) including physical examination and imaging modalities prior to hip arthroscopy, and report current imaging measures used in the diagnosis of FAI. The electronic databases MEDLINE, EMBASE and PubMed were searched and screened in duplicate for relevant studies. Data regarding patient demographics, non-operative treatment, preoperative assessment including physical examination and imaging prior to hip arthroscopy were abstracted. Study quality was assessed in duplicate using the Methodological Index for Non-Randomized Studies criteria. Sixty-eight studies of fair quality evidence that involved a total of 5125 patients (5400 hips) were included. In total, 56% of all patients were male and mean age was 36 years (SD ± 10.0). Within physical examination, FADIR impingement testing was reported in 57% of patients. All included studies reported plain radiographic imaging as a component of preoperative assessment with anterior-posterior pelvis view being the most commonly reported view, followed by the cross-table lateral and Dunn views. Magnetic resonance imaging was obtained for 52% of included patients and computed tomography for 26% of patients. The most commonly reported measure within imaging for the diagnosis of cam type impingement was alpha angle (66%), whereas for pincer type impingement, the cross-over sign (48%) was most reported. Preoperative assessment is underreported in the FAI literature. Improved reporting is warranted to develop a more consistent and validated diagnostic algorithm for FAI to enhance patient selection. Level of evidence : Level IV, Systematic Review of Level I-IV Studies.

  18. Preoperative physical examination and imaging of femoroacetabular impingement prior to hip arthroscopy—a systematic review

    Science.gov (United States)

    Haldane, Chloe E.; Ekhtiari, Seper; de SA, Darren; Simunovic, Nicole

    2017-01-01

    Abstract The purpose of this systematic review is to report current preoperative assessment for femoroacetabular impingement (FAI) including physical examination and imaging modalities prior to hip arthroscopy, and report current imaging measures used in the diagnosis of FAI. The electronic databases MEDLINE, EMBASE and PubMed were searched and screened in duplicate for relevant studies. Data regarding patient demographics, non-operative treatment, preoperative assessment including physical examination and imaging prior to hip arthroscopy were abstracted. Study quality was assessed in duplicate using the Methodological Index for Non-Randomized Studies criteria. Sixty-eight studies of fair quality evidence that involved a total of 5125 patients (5400 hips) were included. In total, 56% of all patients were male and mean age was 36 years (SD ± 10.0). Within physical examination, FADIR impingement testing was reported in 57% of patients. All included studies reported plain radiographic imaging as a component of preoperative assessment with anterior–posterior pelvis view being the most commonly reported view, followed by the cross-table lateral and Dunn views. Magnetic resonance imaging was obtained for 52% of included patients and computed tomography for 26% of patients. The most commonly reported measure within imaging for the diagnosis of cam type impingement was alpha angle (66%), whereas for pincer type impingement, the cross-over sign (48%) was most reported. Preoperative assessment is underreported in the FAI literature. Improved reporting is warranted to develop a more consistent and validated diagnostic algorithm for FAI to enhance patient selection. Level of evidence: Level IV, Systematic Review of Level I–IV Studies. PMID:28948032

  19. A Quick Reference on Respiratory Acidosis.

    Science.gov (United States)

    Johnson, Rebecca A

    2017-03-01

    Respiratory acidosis, or primary hypercapnia, occurs when carbon dioxide production exceeds elimination via the lung and is mainly owing to alveolar hypoventilation. Concurrent increases in Paco 2 , decreases in pH and compensatory increases in blood HCO 3 - concentration are associated with respiratory acidosis. Respiratory acidosis can be acute or chronic, with initial metabolic compensation to increase HCO 3 - concentrations by intracellular buffering. Chronic respiratory acidosis results in longer lasting increases in renal reabsorption of HCO 3 - . Alveolar hypoventilation and resulting respiratory acidosis may also be associated with hypoxemia, especially evident when patients are inspiring room air (20.9% O 2 ). Copyright © 2016 Elsevier Inc. All rights reserved.

  20. History of mechanical ventilation may affect respiratory mechanics evolution in acute respiratory distress syndrome.

    Science.gov (United States)

    Koutsoukou, Antonia; Perraki, Helen; Orfanos, Stylianos E; Koulouris, Nikolaos G; Tromaropoulos, Andreas; Sotiropoulou, Christina; Roussos, Charis

    2009-12-01

    The aim of this study was to investigate the effect of mechanical ventilation (MV) before acute respiratory distress syndrome (ARDS) on subsequent evolution of respiratory mechanics and blood gases in protectively ventilated patients with ARDS. Nineteen patients with ARDS were stratified into 2 groups according to ARDS onset relative to the onset of MV: In group A (n = 11), MV was applied at the onset of ARDS; in group B (n = 8), MV had been initiated before ARDS. Respiratory mechanics and arterial blood gas were assessed in early (protectively ventilated patients with ARDS, late alteration of respiratory mechanics occurs more commonly in patients who have been ventilated before ARDS onset, suggesting that the history of MV affects the subsequent progress of ARDS even when using protective ventilation.

  1. Respiratory diseases and their effects on respiratory function and exercise capacity.

    Science.gov (United States)

    Van Erck-Westergren, E; Franklin, S H; Bayly, W M

    2013-05-01

    Given that aerobic metabolism is the predominant energy pathway for most sports, the respiratory system can be a rate-limiting factor in the exercise capacity of fit and healthy horses. Consequently, respiratory diseases, even in mild forms, are potentially deleterious to any athletic performance. The functional impairment associated with a respiratory condition depends on the degree of severity of the disease and the equestrian discipline involved. Respiratory abnormalities generally result in an increase in respiratory impedance and work of breathing and a reduced level of ventilation that can be detected objectively by deterioration in breathing mechanics and arterial blood gas tensions and/or lactataemia. The overall prevalence of airway diseases is comparatively high in equine athletes and may affect the upper airways, lower airways or both. Diseases of the airways have been associated with a wide variety of anatomical and/or inflammatory conditions. In some instances, the diagnosis is challenging because conditions can be subclinical in horses at rest and become clinically relevant only during exercise. In such cases, an exercise test may be warranted in the evaluation of the patient. The design of the exercise test is critical to inducing the clinical signs of the problem and establishing an accurate diagnosis. Additional diagnostic techniques, such as airway sampling, can be valuable in the diagnosis of subclinical lower airway problems that have the capacity to impair performance. As all these techniques become more widely used in practice, they should inevitably enhance veterinarians' diagnostic capabilities and improve their assessment of treatment effectiveness and the long-term management of equine athletes. © 2013 EVJ Ltd.

  2. How far can we explain the social class differential in respiratory function? A cross-sectional population study of 21,991 men and women from EPIC-Norfolk

    International Nuclear Information System (INIS)

    McFadden, Emily; Luben, Robert; Wareham, Nicholas; Bingham, Sheila; Khaw, Kay-Tee

    2009-01-01

    The objective of this study is to investigate the association between occupational social class and respiratory function, as measured by forced expiratory volume in one-second (FEV 1 ). We examined the cross sectional relationship between lung function and social class in a population study of 21,991 men and women aged 39-79 years living in the general community in Norfolk, United Kingdom, recruited using general practice age-sex registers in 1993-1997. There was a significant socioeconomic gradient in age adjusted lung function with a difference of 0.37 in mean FEV 1 in men and 0.20 in women, respectively between social class I and V. The age adjusted OR for having poor lung function was 4.13 (95% CI 2.66-6.42) in men and 2.64 (95% CI 1.74-3.99) in women for social class V compared to I. This difference was substantially attenuated after adjustment for height, weight, smoking status, respiratory illness, educational level, living in a deprived area, physical activity and plasma vitamin C levels. There was a strong socioeconomic gradient in respiratory function. In men the gradient appeared to be largely explained by smoking status and height; in women a large part of the gradient was explained by potentially modifiable factors. This suggests that socioeconomic inequalities in respiratory function may be preventable or modifiable and highlights factors for further exploration

  3. Long-term exposure to gaseous air pollutants and cardio-respiratory mortality in Brisbane, Australia

    Directory of Open Access Journals (Sweden)

    Xiao Yu Wang

    2009-05-01

    Full Text Available This study examines the association of long-term exposure to gaseous air pollution with cardio-respiratory mortality in Brisbane, Australia, in the period 1996-2004. The pollutant concentrations were estimated using geographical information system (GIS techniques at the statistical local area (SLA level. The generalized estimating equations model was used to investigate the impact of nitrogen dioxide (NO2, ozone (O3 and sulphur dioxide (SO2 on mortality due to cardio-respiratory disease after adjusting for a range of potential confounders. An increase of 4.7% (95% confidence interval = 0.7-8.9% in cardio-respiratory mortality for 1 part per billion (ppb increment in annual average concentration of SO2 was estimated. However, there was no significant association between long-term exposures to NO2 or O3 and death due to cardio-respiratory disease. The results indicate that the annual average concentration of SO2 is associated with cardio-respiratory mortality at the SLA level and this association appears to vary with the geographical area.

  4. MOTIVATIONAL CLUSTER PROFILES OF ADOLESCENT ATHLETES: AN EXAMINATION OF DIFFERENCES IN PHYSICAL-SELF PERCEPTION

    Directory of Open Access Journals (Sweden)

    Emine Çağlar

    2010-06-01

    Full Text Available The primary purpose of the present study was to identify motivational profiles of adolescent athletes using cluster analysis in non-Western culture. A second purpose was to examine relationships between physical self-perception differences of adolescent athletes and motivational profiles. One hundred and thirty six male (Mage = 17.46, SD = 1.25 years and 80 female adolescent athletes (Mage = 17.61, SD = 1.19 years from a variety of team sports including basketball, soccer, volleyball, and handball volunteered to participate in this study. The Sport Motivation Scale (SMS and Physical Self-Perception Profile (PSPP were administered to all participants. Hierarchical cluster analysis revealed a four-cluster solution for this sample: amotivated, low motivated, moderate motivated, and highly motivated. A 4 x 5 (Cluster x PSPP Subscales MANOVA revealed no significant main effect of motivational clusters on physical self-perception levels (p > 0.05. As a result, findings of the present study showed that motivational types of the adolescent athletes constituted four different motivational clusters. Highly and moderate motivated athletes consistently scored higher than amotivated athletes on the perceived sport competence, physical condition, and physical self-worth subscales of PSPP. This study identified motivational profiles of competitive youth-sport participants

  5. The Association between leisure time physical activity and smoking in adolescence: an examination of potential mediating and moderating factors

    DEFF Research Database (Denmark)

    Verkooijen, Kirsten; Nielsen, Gert A; Kremers, Stef P J

    2008-01-01

    BACKGROUND: Although physical activity has been associated negatively with smoking in adolescence, the association is not well understood. PURPOSE: This study examines the relationship between adolescents' leisure time physical activity and smoking behavior, while considering BMI, weight concern,...

  6. Correlation between the respiratory waveform measured using a respiratory sensor and 3D tumor motion in gated radiotherapy

    International Nuclear Information System (INIS)

    Tsunashima, Yoshikazu; Sakae, Takeji; Shioyama, Yoshiyuki; Kagei, Kenji; Terunuma, Toshiyuki; Nohtomi, Akihiro; Akine, Yasuyuki

    2004-01-01

    Purpose: The purpose of this study is to investigate the correlation between the respiratory waveform measured using a respiratory sensor and three-dimensional (3D) tumor motion. Methods and materials: A laser displacement sensor (LDS: KEYENCE LB-300) that measures distance using infrared light was used as the respiratory sensor. This was placed such that the focus was in an area around the patient's navel. When the distance from the LDS to the body surface changes as the patient breathes, the displacement is detected as a respiratory waveform. To obtain the 3D tumor motion, a biplane digital radiography unit was used. For the tumor in the lung, liver, and esophagus of 26 patients, the waveform was compared with the 3D tumor motion. The relationship between the respiratory waveform and the 3D tumor motion was analyzed by means of the Fourier transform and a cross-correlation function. Results: The respiratory waveform cycle agreed with that of the cranial-caudal and dorsal-ventral tumor motion. A phase shift observed between the respiratory waveform and the 3D tumor motion was principally in the range 0.0 to 0.3 s, regardless of the organ being measured, which means that the respiratory waveform does not always express the 3D tumor motion with fidelity. For this reason, the standard deviation of the tumor position in the expiration phase, as indicated by the respiratory waveform, was derived, which should be helpful in suggesting the internal margin required in the case of respiratory gated radiotherapy. Conclusion: Although obtained from only a few breathing cycles for each patient, the correlation between the respiratory waveform and the 3D tumor motion was evident in this study. If this relationship is analyzed carefully and an internal margin is applied, the accuracy and convenience of respiratory gated radiotherapy could be improved by use of the respiratory sensor.Thus, it is expected that this procedure will come into wider use

  7. Association between psoriasis and leisure-time physical activity: findings from the National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Do, Young Kyung; Lakhani, Naheed; Malhotra, Rahul; Halstater, Brian; Theng, Colin; Østbye, Truls

    2015-02-01

    Despite evidence that physical activity can reduce the cardiometabolic risk of patients with psoriasis, these patients may engage in less physical activity than those without psoriasis. The aim of this study was to examine the association of the extent of psoriatic skin lesions with the likelihood of participating in leisure-time moderate to vigorous physical activity (MVPA) and metabolic equivalent task (MET)-minutes of MVPA amongst those who participated. The National Health and Nutrition Examination Survey (NHANES) is a population-based survey among U.S. adults. A total of 6549 persons aged 20-59 years responded to the 2003-2006 NHANES dermatology questionnaires, which asked about participation in leisure-time MVPA and MET-minutes of MVPA amongst those who participated. Compared with individuals without psoriasis, those with psoriasis were less likely to have engaged in leisure MVPA in the past 30 days, although this association was not statistically significant. Amongst those who participated in leisure-time MVPA, MET-minutes of leisure-time MVPA were lower on average for patients currently having few to extensive cutaneous lesions (but not for those currently having little or no psoriatic patches), relative to individuals never diagnosed with psoriasis by approximately 30%. Clinicians should encourage patients with psoriasis, especially those with more severe disease, to be more physically active; they should help identify and address possible psychological and physical barriers to their patients' physical activity. © 2014 Japanese Dermatological Association.

  8. The viper fangs: clinical anatomy, principles of physical examination and therapy (a review

    Directory of Open Access Journals (Sweden)

    Matteo Oliveri

    2016-01-01

    Full Text Available The assessment of fangs is a fundamental part of clinical examination of viperid snakes. The long curved venom fang is carried by short, highly mobile maxilla. Short anaesthesia is advised for safe physical examination and radiography of the mouth cavity. The fangs are gently forced outside the fang pocket by passing the bar or forceps on the palato-maxillary arch, and rotating them rostrally shifting the mucosal fold. Functional fangs are periodically shed and several generations of replacement teeth lie behind and beneath each fang. In case of fang fracture, therapy should be limited to flushing with a solution of chlorhexidine or povidone iodine, and topical application of pro-coagulant and antibacterial cream. Therapy of chronic fang inflammation is based on removal of necrotized fang and repeated abundant irrigation of the fang pocket. Treatment of chronic stomatitis consists of flushing with chlorhexidine or povidone iodine, physical removal of the plaques, administration of analgesics and antibiotics (marbofloxacin, enrofloxacin or ceftazidime. Extra-oral surgical approach is the best method for odontogenic abscess removal. A vigorous flushing with sterile saline solution, chlorhexidine and povidone iodine and topical application of antibiotics (antibiotic embedded surgical sponge is advised. Force feeding of the anorectic patient suffering from fang inflammation is a mandatory part of the standard treatment protocol.

  9. Seasonality of long term wheezing following respiratory syncytial virus lower respiratory tract infection

    NARCIS (Netherlands)

    Bont, L.; Steijn, M.; van Aalderen, W. M. C.; Brus, F.; Th Draaisma, J. M.; van Diemen-Steenvoorde, R. A. A. M.; Pekelharing-Berghuis, M.; Kimpen, J. L. L.

    2004-01-01

    Background: It is well known that respiratory syncytial virus (RSV) lower respiratory tract infection (LRTI) is associated with subsequent wheezing episodes, but the precise natural course of wheezing following RSV LRTI is not known. This study aimed to determine the continuous development of

  10. Seasonality of long term wheezing following respiratory syncytial virus lower respiratory tract infection

    NARCIS (Netherlands)

    Bont, L; Steijn, M; van Aalderen, WMC; Brus, F; Draaisma, JMT; Van Diemen-Steenvoorde, RAAM; Pekelharing-Berghuis, M; Kimpen, JLL

    Background: It is well known that respiratory syncytial virus (RSV) lower respiratory tract infection (LRTI) is associated with subsequent wheezing episodes, but the precise natural course of wheezing following RSV LRTI is not known. This study aimed to determine the continuous development of

  11. Association between Patient History and Physical Examination and Osteoarthritis after Ankle Sprain.

    Science.gov (United States)

    van Ochten, John M; de Vries, Anja D; van Putte, Nienke; Oei, Edwin H G; Bindels, Patrick J E; Bierma-Zeinstra, Sita M A; van Middelkoop, Marienke

    2017-09-01

    Structural abnormalities on MRI are frequent after an ankle sprain. To determine the association between patient history, physical examination and early osteoarthritis (OA) in patients after a previous ankle sprain, 98 patients with persistent complaints were selected from a cross-sectional study. Patient history taking and physical examination were applied and MRI was taken. Univariate and multivariable analyses were used to test possible associations. Signs of OA (cartilage loss, osteophytes and bone marrow edema) were seen in the talocrural joint (TCJ) in 40% and the talonavicular joint (TNJ) in 49%. Multivariable analysis showed a significant positive association between swelling (OR 3.58, 95%CI 1.13;11.4), a difference in ROM of passive plantar flexion (OR 1.09, 95%CI 1.01;1.18) and bone edema in the TCJ. A difference in ROM of passive plantar flexion (OR 1.07, 95%CI 1.00;1.15) and pain at the end range of dorsiflexion/plantar flexion (OR 5.23, 95%CI 1.88;14.58) were associated with osteophytes in the TNJ. Pain at the end of dorsiflexion/plantar flexion, a difference in ROM of passive plantar flexion and swelling seem to be associated with features of OA (bone marrow edema, osteophytes) in the TCJ and TNJ. Our findings may guide physicians to predict structural joint abnormalities as signs of osteoarthritis. 1b. © Georg Thieme Verlag KG Stuttgart · New York.

  12. Respiratory health effects of exposure to low levels of airborne endotoxin - a systematic review.

    Science.gov (United States)

    Farokhi, Azadèh; Heederik, Dick; Smit, Lidwien A M

    2018-02-08

    Elevated endotoxin levels have been measured in ambient air around livestock farms, which is a cause of concern for neighbouring residents. There is clear evidence that occupational exposure to high concentrations of airborne endotoxin causes respiratory inflammation, respiratory symptoms and lung function decline. However, health effects of exposure to low levels of endotoxin are less well described. The aim of this systematic review is to summarize published associations between exposure to relatively low levels of airborne endotoxin and respiratory health endpoints. Studies investigating respiratory effects of measured or modelled exposure to low levels of airborne endotoxin (average effects of exposure to low levels of endotoxin on respiratory symptoms and lung function. However, considerable heterogeneity existed in the outcomes of the included studies and no overall estimate could be provided by meta-analysis to quantify the possible relationship. Instead, a best evidence synthesis was performed among studies examining the exposure-response relationship between endotoxin and respiratory outcomes. Significant exposure-response relationships between endotoxin and symptoms and FEV 1 were shown in several studies, with no conflicting findings in the studies included in the best evidence synthesis. Significantly different effects of endotoxin exposure were also seen in vulnerable subgroups (atopics and patients with broncho-obstructive disease) and smokers. Respiratory health effects of exposure to low levels of airborne endotoxin (health effects, especially in vulnerable subgroups of the population.

  13. Effects of wheelchair sports on respiratory muscle strength and thoracic mobility of individuals with spinal cord injury.

    Science.gov (United States)

    Moreno, Marlene Aparecida; Zamunér, Antonio Roberto; Paris, Juliana Viana; Teodori, Rosana Macher; Barros, Ricardo M L

    2012-06-01

    The aim of this study was to evaluate the effects of wheelchair sports on respiratory muscle strength and the thoracic mobility of individuals with spinal cord injury. Thirty male subjects with chronic spinal cord injury (American Spinal Injury Association Impairment Scale grade A) took part in the study and were divided into four groups: sedentary subjects with quadriplegia (S-QUAD, n = 7), wheelchair rugby athletes with quadriplegia (A-QUAD, n = 8), sedentary subjects with paraplegia (S-PARA, n = 6), and wheelchair basketball athletes with paraplegia (A-PARA, n = 9). The main outcome measures were maximal inspiratory and expiratory pressure and the respiratory coefficients at the axillary and xiphoid levels. A-QUAD group presented values significantly higher for all respiratory variables studied compared with the S-QUAD group. No significant differences in any of the respiratory variables were observed between S-PARA and A-PARA groups. There was a negative correlation between spinal cord injury level and respiratory variables for the S-QUAD and S-PARA groups. There were positive correlations in the A-QUAD group between time of training and maximal inspiratory pressure (adjusted R = 0.84; P = 0.001) and respiratory coefficients at the axillary level (adjusted R = 0.80; P = 0.002). Physical training seems to have a positive influence on respiratory muscle strength and thoracic mobility, especially in subjects with quadriplegia.

  14. The association between leisure time physical activity and smoking in adolescence: an examination of potential mediating and moderating factors

    NARCIS (Netherlands)

    Verkooijen, K.T.; Nielsen, G.A.; Kremers, S.P.J.

    2008-01-01

    Although physical activity has been associated negatively with smoking in adolescence, the association is not well understood. Purpose: This study examines the relationship between adolescents' leisure time physical activity and smoking behavior, while considering BMI, weight concern, sense of

  15. Visual aided pacing in respiratory maneuvers

    Energy Technology Data Exchange (ETDEWEB)

    Rambaudi, L R [Laboratorio de Biofisica y Fisiologia ' Antonio Sadi Frumento' (Argentina); Rossi, E [Catedra de Bioingenieria II (Argentina); Mantaras, M C [Catedra de Bioingenieria II (Argentina); Perrone, M S [Laboratorio de Biofisica y Fisiologia ' Antonio Sadi Frumento' (Argentina); Siri, L Nicola [Catedra de Bioingenieria II (Argentina)

    2007-11-15

    A visual aid to pace self-controlled respiratory cycles in humans is presented. Respiratory manoeuvres need to be accomplished in several clinic and research procedures, among others, the studies on Heart Rate Variability. Free running respiration turns to be difficult to correlate with other physiologic variables. Because of this fact, voluntary self-control is asked from the individuals under study. Currently, an acoustic metronome is used to pace respiratory frequency, its main limitation being the impossibility to induce predetermined timing in the stages within the respiratory cycle. In the present work, visual driven self-control was provided, with separate timing for the four stages of a normal respiratory cycle. This visual metronome (ViMet) was based on a microcontroller which power-ON and -OFF an eight-LED bar, in a four-stage respiratory cycle time series handset by the operator. The precise timing is also exhibited on an alphanumeric display.

  16. Visual aided pacing in respiratory maneuvers

    International Nuclear Information System (INIS)

    Rambaudi, L R; Rossi, E; Mantaras, M C; Perrone, M S; Siri, L Nicola

    2007-01-01

    A visual aid to pace self-controlled respiratory cycles in humans is presented. Respiratory manoeuvres need to be accomplished in several clinic and research procedures, among others, the studies on Heart Rate Variability. Free running respiration turns to be difficult to correlate with other physiologic variables. Because of this fact, voluntary self-control is asked from the individuals under study. Currently, an acoustic metronome is used to pace respiratory frequency, its main limitation being the impossibility to induce predetermined timing in the stages within the respiratory cycle. In the present work, visual driven self-control was provided, with separate timing for the four stages of a normal respiratory cycle. This visual metronome (ViMet) was based on a microcontroller which power-ON and -OFF an eight-LED bar, in a four-stage respiratory cycle time series handset by the operator. The precise timing is also exhibited on an alphanumeric display

  17. Does This Child Have Pneumonia?: The Rational Clinical Examination Systematic Review.

    Science.gov (United States)

    Shah, Sonal N; Bachur, Richard G; Simel, David L; Neuman, Mark I

    2017-08-01

    Pneumonia is a leading cause of morbidity and mortality in children. It is important to identify the clinical symptoms and physical examination findings associated with pneumonia to improve timely diagnosis, prevent significant morbidity, and limit antibiotic overuse. To systematically review the accuracy of symptoms and physical examination findings in identifying children with radiographic pneumonia. MEDLINE and Embase (1956 to May 2017) were searched, along with reference lists from retrieved articles, to identify diagnostic studies of pediatric pneumonia across a broad age range that had to include children younger than age 5 years (although some studies enrolled children up to age 19 years); 3644 unique articles were identified, of which 23 met inclusion criteria. Two authors independently abstracted raw data and assessed methodological quality. A third author resolved disputes. Likelihood ratios (LRs), sensitivity, and specificity were calculated for individual symptoms and physical examination findings for the diagnosis of pneumonia. An infiltrate on chest radiograph was considered the reference standard for the diagnosis of pneumonia. Twenty-three prospective cohort studies of children (N = 13 833) with possible pneumonia were included (8 from North America), with a range of 78 to 2829 patients per study. The prevalence of radiographic pneumonia in North American studies was 19% (95% CI, 11%-31%) and 37% (95% CI, 26%-50%) outside of North America. No single symptom was strongly associated with pneumonia; however, the presence of chest pain in 2 studies that included adolescents was associated with pneumonia (LR, 1.5-5.5; sensitivity, 8%-14%; specificity, 94%-97%). Vital sign abnormalities such as fever (temperature >37.5°C [LR range, 1.7-1.8]; sensitivity, 80%-92%; specificity, 47%-54%) and tachypnea (respiratory rate >40 breaths/min; LR, 1.5 [95% CI, 1.3-1.7]; sensitivity, 79%; specificity, 51%) were not strongly associated with pneumonia diagnosis

  18. Impact of NOx Emission Reduction Policy on Hospitalizations for Respiratory Disease in New York State

    Science.gov (United States)

    To date, only a limited number of studies have examined the impact of ambient pollutant policy on respiratory morbidities. This accountability study examined the effect of a regional pollution control policy, namely, the US Environmental Protection Agency’s (EPA) nitrogen oxides ...

  19. Human respiratory syncytial virus load normalized by cell quantification as predictor of acute respiratory tract infection.

    Science.gov (United States)

    Gómez-Novo, Miriam; Boga, José A; Álvarez-Argüelles, Marta E; Rojo-Alba, Susana; Fernández, Ana; Menéndez, María J; de Oña, María; Melón, Santiago

    2018-05-01

    Human respiratory syncytial virus (HRSV) is a common cause of respiratory infections. The main objective is to analyze the prediction ability of viral load of HRSV normalized by cell number in respiratory symptoms. A prospective, descriptive, and analytical study was performed. From 7307 respiratory samples processed between December 2014 to April 2016, 1019 HRSV-positive samples, were included in this study. Low respiratory tract infection was present in 729 patients (71.54%). Normalized HRSV load was calculated by quantification of HRSV genome and human β-globin gene and expressed as log10 copies/1000 cells. HRSV mean loads were 4.09 ± 2.08 and 4.82 ± 2.09 log10 copies/1000 cells in the 549 pharyngeal and 470 nasopharyngeal samples, respectively (P respiratory tract infection and 4.22 ± 2.28 log10 copies/1000 cells with upper respiratory tract infection or febrile syndrome (P < 0.05). A possible cut off value to predict LRTI evolution was tentatively established. Normalization of viral load by cell number in the samples is essential to ensure an optimal virological molecular diagnosis avoiding that the quality of samples affects the results. A high viral load can be a useful marker to predict disease progression. © 2018 Wiley Periodicals, Inc.

  20. The impact of respiratory motion on tumor quantification and delineation in static PET/CT imaging

    International Nuclear Information System (INIS)

    Liu Chi; Pierce II, Larry A; Alessio, Adam M; Kinahan, Paul E

    2009-01-01

    Our aim is to investigate the impact of respiratory motion on tumor quantification and delineation in static PET/CT imaging using a population of patient respiratory traces. A total of 1295 respiratory traces acquired during whole body PET/CT imaging were classified into three types according to the qualitative shape of their signal histograms. Each trace was scaled to three diaphragm motion amplitudes (6 mm, 11 mm and 16 mm) to drive a whole body PET/CT computer simulation that was validated with a physical phantom experiment. Three lung lesions and one liver lesion were simulated with diameters of 1 cm and 2 cm. PET data were reconstructed using the OS-EM algorithm with attenuation correction using CT images at the end-expiration phase and respiratory-averaged CT. The errors of the lesion maximum standardized uptake values (SUV max ) and lesion volumes between motion-free and motion-blurred PET/CT images were measured and analyzed. For respiration with 11 mm diaphragm motion and larger quiescent period fraction, respiratory motion can cause a mean lesion SUV max underestimation of 28% and a mean lesion volume overestimation of 130% in PET/CT images with 1 cm lesions. The errors of lesion SUV max and volume are larger for patient traces with larger motion amplitudes. Smaller lesions are more sensitive to respiratory motion than larger lesions for the same motion amplitude. Patient respiratory traces with relatively larger quiescent period fraction yield results less subject to respiratory motion than traces with long-term amplitude variability. Mismatched attenuation correction due to respiratory motion can cause SUV max overestimation for lesions in the lower lung region close to the liver dome. Using respiratory-averaged CT for attenuation correction yields smaller mismatch errors than those using end-expiration CT. Respiratory motion can have a significant impact on static oncological PET/CT imaging where SUV and/or volume measurements are important. The impact

  1. Postoperative chest physical therapy prevents respiratory complications in patients undergoing esophagectomy Fisioterapia respiratória pós-operatória previne complicações respiratórias em pacientes submetidos à esofagectomia

    Directory of Open Access Journals (Sweden)

    Adriana C. Lunardi

    2011-04-01

    Full Text Available BACKGROUND: Esophagectomy presents the highest rate of postoperative pulmonary complications among all types of upper abdominal surgery. The benefits of chest physical therapy in patients undergoing upper abdominal surgery have been shown by many studies; however, its specific effect in patients receiving esophagectomy has been seldom investigated. OBJECTIVES: This study aimed to compare the frequency of respiratory complications in patients undergoing esophagectomy receiving chest physical therapy compared to no treatment. METHODS: 70 consecutive patients were evaluated retrospectively and allocated to two groups: control group (CG=no physical therapy; n=30 and chest physical therapy group (PTG; n=40. Patients received chest physical therapy which includes lung re-expansion and airway clearance maneuvers. They were not submitted to either noninvasive ventilation or exercises with devices that generate airways positive pressure. All patients were instructed to early mobilization. Information about pre-operative and respiratory complications were collected. Statistic analysis to compare the frequency of respiratory complications was performed by the Z test. The significance level was set to 5%. RESULTS: Patients in the CG and PTG were similar in terms of age, BMI, smoking and drinking status, malignant diseases, surgical and anesthesia duration and types of esophagectomy (p>0.05. Our results show that patients received chest physical therapy after esophagectomy had a lower frequency of respiratory complications (15% vs. 37%, pCONTEXTUALIZAÇÃO: A esofagectomia apresenta a maior taxa de complicações pulmonares pós-operatórias dentre as cirurgias abdominais altas. Os benefícios da fisioterapia respiratória em pacientes submetidos à cirurgia abdominal alta convencional têm sido mostrados na literatura, porém esse efeito na esofagectomia tem sido pouco investigado. OBJETIVOS: Comparar a frequência de complicações respiratórias em dois

  2. Association of nicotinic acetylcholine receptors with central respiratory control in isolated brainstem-spinal cord preparation of neonatal rats

    Directory of Open Access Journals (Sweden)

    EIKI HATORI

    2006-01-01

    Full Text Available Nicotine exposure is a risk factor in several breathing disorders Nicotinic acetylcholine receptors (nAChRs exist in the ventrolateral medulla, an important site for respiratory control. We examined the effects of nicotinic acetylcholine neurotransmission on central respiratory control by addition of a nAChR agonist or one of various antagonists into superfusion medium in the isolated brainstem-spinal cord from neonatal rats. Ventral C4 neuronal activity was monitored as central respiratory output, and activities of respiratory neurons in the ventrolateral medulla were recorded in whole-cell configuration. RJR-2403 (0.1-10mM, alpha4beta2 nAChR agonist induced dose-dependent increases in respiratory frequency. Non-selective nAChR antagonist mecamylamine (0.1-100mM, alpha4beta2 antagonist dihydro-beta-erythroidine (0.1-100mM, alpha7 antagonist methyllycaconitine (0.1-100mM, and a-bungarotoxin (0.01-10mM all induced dose-dependent reductions in C4 respiratory rate. We next examined effects of 20mM dihydro-beta-erythroidine and 20mM methyllycaconitine on respiratory neurons. Dihydro-beta-erythroidine induces hyperpolarization and decreases intraburst firing frequency of inspiratory and preinspiratory neurons. In contrast, methyllycaconitine has no effect on the membrane potential of inspiratory neurons, but does decrease their intraburst firing frequency while inducing hyperpolarization and decreasing intraburst firing frequency in preinspiratory neurons. These findings indicate that alpha4beta2 nAChR is involved in both inspiratory and preinspiratory neurons, whereas alpha7 nAChR functions only in preinspiratory neurons to modulate C4 respiratory rate

  3. Metal Dust Exposure and Respiratory Health of Male Steel Work¬ers in Terengganu, Malaysia

    OpenAIRE

    Nurul Ainun HAMZAH; Shamsul Bahri MOHD TAMRIN; Noor Hassim ISMAIL

    2015-01-01

    Background: This cross sectional study was carried out to determine the relationship between metal dust exposure and respiratory health in male steel workers in Terengganu, Malaysia.Methods: Subjects were interviewed using a structured questionnaire from British Medical Research Council (BMRC) Questionnaire regarding respiratory symptoms and were examined their lung function using spirometer.Results: The mean trace metal dusts concentration TWA8 for cobalt and chromium in most of work unit ex...

  4. 29 CFR 1915.154 - Respiratory protection.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 7 2010-07-01 2010-07-01 false Respiratory protection. 1915.154 Section 1915.154 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR... (PPE) § 1915.154 Respiratory protection. Respiratory protection for shipyard employment is covered by...

  5. 33 CFR 127.1209 - Respiratory protection.

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Respiratory protection. 127.1209... Waterfront Facilities Handling Liquefied Hazardous Gas Equipment § 127.1209 Respiratory protection. Each waterfront facility handling LHG must provide equipment for respiratory protection for each employee of the...

  6. Robust real-time extraction of respiratory signals from PET list-mode data.

    Science.gov (United States)

    Salomon, Andre; Zhang, Bin; Olivier, Patrick; Goedicke, Andreas

    2018-05-01

    Respiratory motion, which typically cannot simply be suspended during PET image acquisition, affects lesions' detection and quantitative accuracy inside or in close vicinity to the lungs. Some motion compensation techniques address this issue via pre-sorting ("binning") of the acquired PET data into a set of temporal gates, where each gate is assumed to be minimally affected by respiratory motion. Tracking respiratory motion is typically realized using dedicated hardware (e.g. using respiratory belts and digital cameras). Extracting respiratory signalsdirectly from the acquired PET data simplifies the clinical workflow as it avoids to handle additional signal measurement equipment. We introduce a new data-driven method "Combined Local Motion Detection" (CLMD). It uses the Time-of-Flight (TOF) information provided by state-of-the-art PET scanners in order to enable real-time respiratory signal extraction without additional hardware resources. CLMD applies center-of-mass detection in overlapping regions based on simple back-positioned TOF event sets acquired in short time frames. Following a signal filtering and quality-based pre-selection step, the remaining extracted individual position information over time is then combined to generate a global respiratory signal. The method is evaluated using 7 measured FDG studies from single and multiple scan positions of the thorax region, and it is compared to other software-based methods regarding quantitative accuracy and statistical noise stability. Correlation coefficients around 90% between the reference and the extracted signal have been found for those PET scans where motion affected features such as tumors or hot regions were present in the PET field-of-view. For PET scans with a quarter of typically applied radiotracer doses, the CLMD method still provides similar high correlation coefficients which indicates its robustness to noise. Each CLMD processing needed less than 0.4s in total on a standard multi-core CPU

  7. A Study of the Combined Effects of Physical Activity and Air Pollution on Mortality in Elderly Urban Residents

    DEFF Research Database (Denmark)

    Andersen, Zorana Jovanovic; de Nazelle, Audrey; Mendez, Michelle A

    2015-01-01

    BACKGROUND: Physical activity reduces, whereas exposure to air pollution increases the risk of premature mortality. Physical activity amplifies respiratory uptake and deposition of air pollutants in the lung, which may augment acute harmful effects of air pollution during exercise. OBJECTIVES......: To examine whether benefits of physical activity on mortality are moderated by long-term exposure to high air pollution levels in an urban setting. METHODS: 52,061 subjects (50-65 years) from the Danish Diet, Cancer, and Health cohort, living in Aarhus and Copenhagen reported data on physical activity...... exposure (HR = 0.77; 95% CI: 0.54, 1.11 and HR = 0.81; 95% CI: 0.55, 1.18, p-interaction = 0.09 and 0.02, respectively). CONCLUSIONS: In general, exposure to high levels of traffic-related air pollution did not modify associations indicating beneficial effects of physical activity on mortality. These novel...

  8. In Vivo Respiratory-Gated Micro-CT Imaging in Small-Animal Oncology Models

    Directory of Open Access Journals (Sweden)

    Dawn Cavanaugh

    2004-01-01

    Full Text Available Micro-computed tomography (micro-CT is becoming an accepted research tool for the noninvasive examination of laboratory animals such as mice and rats, but to date, in vivo scanning has largely been limited to the evaluation of skeletal tissues. We use a commercially available micro-CT device to perform respiratory gated in vivo acquisitions suitable for thoracic imaging. The instrument is described, along with the scan protocol and animal preparation techniques. Preliminary results confirm that lung tumors as small as 1 mm in diameter are visible in vivo with these methods. Radiation dose was evaluated using several approaches, and was found to be approximately 0.15 Gy for this respiratory-gated micro-CT imaging protocol. The combination of high-resolution CT imaging and respiratory-gated acquisitions appears well-suited to serial in vivo scanning.

  9. Excretion patterns of human metapneumovirus and respiratory syncytial virus among young children

    DEFF Research Database (Denmark)

    von Linstow, Marie-Louise; Eugen-Olsen, Jesper; Koch, A

    2006-01-01

    of the infected children showed to have an upper respiratory tract infection when following up. CONCLUSION: Viral RNA was present in nasal secretions, saliva, sweat, and faeces, but whether or not the virions were infectious and constitute a potential mode of transmission remains to be shown in future studies.......BACKGROUND: As respiratory syncytial virus (RSV) and human metapneumovirus (hMPV) cause serious respiratory tract infections, the routes of transmission of these viruses are important to elucidate. We examined the modes of virus shedding and shedding duration of RSV and hMPV in young children....... METHODS: From each child in a group of 44 children (37 RSV-positive, 6 hMPV-positive, and 1 co-infected child), aged between 0.5-38 months, hospitalised at Hvidovre Hospital, Copenhagen, Denmark, one nasopharyngeal aspirate (NPA), saliva, urine, and faeces sample were collected at inclusion and weekly...

  10. Work-related psychosocial stress as a risk factor for asthma, allergy, and respiratory infections in the Swedish workforce.

    Science.gov (United States)

    Runeson-Broberg, Roma; Norbäck, Dan

    2014-04-01

    This study examined the association between work-related psychosocial stress and asthma, atopy, and respiratory infections. 532 randomly selected occupationally active people (272 men, 260 women; M age = 41 yr., SD = 13) in Sweden participated. Information on history of asthma, atopy, and respiratory infections was collected by a postal self-report questionnaire. Work stress was assessed based on the demands-control-support model. Current asthma and respiratory infections were associated with work-related psychosocial stress. When stratified for sex, these associations were only found in men. Associations between low control, low support, and current asthma were found among young participants ( 40 years) low supervisor support was associated with frequent respiratory infections.

  11. CT digital radiography: Alternative technique for airway evaluation in physically disabled patients

    International Nuclear Information System (INIS)

    Mandell, G.A.; Harcke, H.T.; Brunson, G.; Delengowski, R.; Padman, R.

    1987-01-01

    Evaluation of the airway for the presence of granulation tissue prior to removal of a tracheostomy is essential to prevent sudden respiratory decompensation secondary to obstruction. Airway examination in a brain and/or spinal cord injured patient is especially difficult under fluoroscopy. The patient's lack of mobility results in poor visualization of the trachea, secondary to the overlying dense osseous components of the shoulders and thoracic cage. A CT localization view (digital view), which allows manipulation and magnification of the digital data in order to see the hidden airway and detect associated obstructing lesions, is proffered as an alternative technique to high KV, magnification technique. Thirteen examinations were performed satisfactorily in eleven patients examined by this technique with little expenditure of time, physical exertion, and irradiation. The sensitivity, specificity and accuracy of digital airway examination were 100%, 67% and 92% respectively with bronchoscopy used as the standard. (orig.)

  12. Towards estimation of respiratory muscle effort with respiratory inductance plethysmography signals and complementary ensemble empirical mode decomposition.

    Science.gov (United States)

    Chen, Ya-Chen; Hsiao, Tzu-Chien

    2018-07-01

    Respiratory inductance plethysmography (RIP) sensor is an inexpensive, non-invasive, easy-to-use transducer for collecting respiratory movement data. Studies have reported that the RIP signal's amplitude and frequency can be used to discriminate respiratory diseases. However, with the conventional approach of RIP data analysis, respiratory muscle effort cannot be estimated. In this paper, the estimation of the respiratory muscle effort through RIP signal was proposed. A complementary ensemble empirical mode decomposition method was used, to extract hidden signals from the RIP signals based on the frequency bands of the activities of different respiratory muscles. To validate the proposed method, an experiment to collect subjects' RIP signal under thoracic breathing (TB) and abdominal breathing (AB) was conducted. The experimental results for both the TB and AB indicate that the proposed method can be used to loosely estimate the activities of thoracic muscles, abdominal muscles, and diaphragm. Graphical abstract ᅟ.

  13. Coal Mining-Related Respiratory Diseases

    Science.gov (United States)

    ... Topics Publications and Products Programs Contact NIOSH NIOSH COAL WORKERS' HEALTH SURVEILLANCE PROGRAM Recommend on Facebook Tweet Share Compartir Coal Mining-Related Respiratory Diseases Coal mining-related respiratory ...

  14. Respiratory processes in non-photosynthetic plastids

    Science.gov (United States)

    Renato, Marta; Boronat, Albert; Azcón-Bieto, Joaquín

    2015-01-01

    Chlororespiration is a respiratory process located in chloroplast thylakoids which consists in an electron transport chain from NAD(P)H to oxygen. This respiratory chain involves the NAD(P)H dehydrogenase complex, the plastoquinone pool and the plastid terminal oxidase (PTOX), and it probably acts as a safety valve to prevent the over-reduction of the photosynthetic machinery in stress conditions. The existence of a similar respiratory activity in non-photosynthetic plastids has been less studied. Recently, it has been reported that tomato fruit chromoplasts present an oxygen consumption activity linked to ATP synthesis. Etioplasts and amyloplasts contain several electron carriers and some subunits of the ATP synthase, so they could harbor a similar respiratory process. This review provides an update on the study about respiratory processes in chromoplasts, identifying the major gaps that need to be addressed in future research. It also reviews the proteomic data of etioplasts and amyloplasts, which suggest the presence of a respiratory electron transport chain in these plastids. PMID:26236317

  15. Respiratory processes in non-photosynthetic plastids

    Directory of Open Access Journals (Sweden)

    Marta eRenato

    2015-07-01

    Full Text Available Chlororespiration is a respiratory process located in chloroplast thylakoids which consists in an electron transport chain from NAD(PH to oxygen. This respiratory chain involves the NAD(PH dehydrogenase complex, the plastoquinone pool and the plastid terminal oxidase (PTOX, and it probably acts as a safety valve to prevent the over-reduction of the photosynthetic machinery in stress conditions. The existence of a similar respiratory activity in non-photosynthetic plastids has been less studied. Recently, it has been reported that tomato fruit chromoplasts present an oxygen consumption activity linked to ATP synthesis. Etioplasts and amyloplasts contain several electron carriers and some subunits of the ATP synthase, so they could harbor a similar respiratory process. This review provides an update on the study about respiratory processes in chromoplasts, identifying the major gaps that need to be addressed in future research. It also reviews the proteomic data of etioplasts and amyloplasts, which suggest the presence of a respiratory electron transport chain in these plastids.

  16. Respiratory care management information systems.

    Science.gov (United States)

    Ford, Richard M

    2004-04-01

    Hospital-wide computerized information systems evolved from the need to capture patient information and perform billing and other financial functions. These systems, however, have fallen short of meeting the needs of respiratory care departments regarding work load assessment, productivity management, and the level of outcome reporting required to support programs such as patient-driven protocols. The respiratory care management information systems (RCMIS) of today offer many advantages over paper-based systems and hospital-wide computer systems. RCMIS are designed to facilitate functions specific to respiratory care, including assessing work demand, assigning and tracking resources, charting, billing, and reporting results. RCMIS incorporate mobile, point-of-care charting and are highly configurable to meet the specific needs of individual respiratory care departments. Important and substantial benefits can be realized with an RCMIS and mobile, wireless charting devices. The initial and ongoing costs of an RCMIS are justified by increased charge capture and reduced costs, by way of improved productivity and efficiency. It is not unusual to recover the total cost of an RCMIS within the first year of its operation. In addition, such systems can facilitate and monitor patient-care protocols and help to efficiently manage the vast amounts of information encountered during the practitioner's workday. Respiratory care departments that invest in RCMIS have an advantage in the provision of quality care and in reducing expenses. A centralized respiratory therapy department with an RCMIS is the most efficient and cost-effective way to monitor work demand and manage the hospital-wide allocation of respiratory care services.

  17. Study of montelukast for the treatment of respiratory symptoms of post-respiratory syncytial virus bronchiolitis in children

    DEFF Research Database (Denmark)

    Bisgaard, H.; Flores-Nunez, A.; Goh, A.

    2008-01-01

    RATIONALE: A pilot study (Bisgaard H; Study Group on Montelukast and Respiratory Syncytial Virus. A randomized trial of montelukast in respiratory syncytial virus postbronchiolitis. Am J Respir Crit Care Med 2003;167:379-383) reported the efficacy of montelukast in post-respiratory syncytial viru...

  18. Respiratory medicine of reptiles.

    Science.gov (United States)

    Schumacher, Juergen

    2011-05-01

    Noninfectious and infectious causes have been implicated in the development of respiratory tract disease in reptiles. Treatment modalities in reptiles have to account for species differences in response to therapeutic agents as well as interpretation of diagnostic findings. Data on effective drugs and dosages for the treatment of respiratory diseases are often lacking in reptiles. Recently, advances have been made on the application of advanced imaging modalities, especially computed tomography for the diagnosis and treatment monitoring of reptiles. This article describes common infectious and noninfectious causes of respiratory disease in reptiles, including diagnostic and therapeutic regimen. Copyright © 2011 Elsevier Inc. All rights reserved.

  19. Modifiable variables in physical therapy education programs associated with first-time and three-year National Physical Therapy Examination pass rates in the United States

    Directory of Open Access Journals (Sweden)

    Chad Cook

    2015-09-01

    Full Text Available Purpose: This study aimed to examine the modifiable programmatic characteristics reflected in the Commission on Accreditation in Physical Therapy Education (CAPTE Annual Accreditation Report for all accredited programs that reported pass rates on the National Physical Therapist Examination, and to build a predictive model for first-time and three-year ultimate pass rates. Methods: This observational study analyzed programmatic information from the 185 CAPTE-accredited physical therapy programs in the United States and Puerto Rico out of a total of 193 programs that provided the first-time and three-year ultimate pass rates in 2011. Fourteen predictive variables representing student selection and composition, clinical education length and design, and general program length and design were analyzed against first-time pass rates and ultimate pass rates on the NPTE. Univariate and multivariate multinomial regression analysis for first-time pass rates and logistic regression analysis for three-year ultimate pass rates were performed. Results: The variables associated with the first-time pass rate in the multivariate analysis were the mean undergraduate grade point average (GPA and the average age of the cohort. Multivariate analysis showed that mean undergraduate GPA was associated with the three-year ultimate pass rate. Conclusions: Mean undergraduate GPA was found to be the only modifiable predictor for both first-time and three-year pass rates among CAPTE-accredited physical therapy programs.

  20. Effects of physical examination and diet consultation on serum cholesterol and health-behavior in the Korean pilots employed in commercial airline.

    Science.gov (United States)

    Choi, Yun Young; Kim, Ki Youn

    2013-01-01

    An objective of this study is to search how physical examination and diet consultation can influence those risk factors of cardiovascular disease. The subjects were 326 pilots of the "B" airline company in Korea whose total cholesterol values were over 220 mg/dl on their regular physical examinations from April 2006 to December 2008. They were divided into two groups, one who had diet consultation (an intervention group) and a control group. The physical examination components used to each group were body mass index (BMI), total cholesterol (TC), high density lipoprotein (HDL), low density lipoprotein (LDL) and triglyceride (TG). The behavioral, anthropometric and biomedical measurements were collected at each visit. This study compares and investigates the changes of serum cholesterol and also the health-behavior at each physical examination. Within the intervention group significant improvements were observed for total cholesterol, BMI (body mass index) and HDL (high density lipoprotein). The normalizing rates for cholesterol level to decrease down to lower than 200 mg/dl were 17.7% in intervention group and 8.7% in control group, which is statistically significantly higher among the intervention group. The odds ratio of diet consultation was 2.80 (95% CI=1.35-5.79), which indicates that it is a significantly contributing factor to normalize the serum cholesterol value down to lower than 200 mg/dl. Based on result, it is recommended to have regular physical examination and intensive management with diet and exercise consultation.