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Knee Exam

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941. Superior mesenteric artery syndrome

of worsening symptoms. Fear of eating is a commonly seen among those with the chronic form of SMA syndrome. For many, symptoms are partially relieved when in the left lateral decubitus or knee-to-chest position, or in the prone (face down) position. A , which corresponds to applying pressure below the umbilicus in cephalad and dorsal direction, elevates the root of the SMA, also slightly easing the constriction. Symptoms can be aggravated when leaning to the right or taking a position. Causes [ ] fat (...) the gastroduodenal region. Standard diagnostic exams include abdominal and pelvic (CT) scan with oral and IV contrast, (UGI), and, for equivocal cases, hypotonic duodenography. In addition, vascular imaging studies such as and contrast may be used to indicate increased bloodflow velocity through the SMA or a narrowed SMA angle. Despite multiple case reports, there has been controversy surrounding the diagnosis and even the existence of SMA syndrome since symptoms do not always correlate well with radiologic

2012 Wikipedia

942. Warren Fales Draper

from , . Margaret had attended Smith College in , Massachusetts, earning a degree in . A month after his marriage, Draper earned his degree, then went to Washington D.C. to take the entrance exam. In June, he and Margaret went to a summer cottage in awaiting the exam results and news of his first assignment. Years in the Public Health Service [ ] West Coast duty [ ] Draper finished second on the Public Health Service exam, out of about 25 examinees, and in August 1910 reported to his first (...) , whip up some betting and try to make some money. I sold the idea to other members of the class and soon we had chalk lanes mapped out on the floor, a turtle with a number on its back assigned to each member, and were down on our knees, snapping our fingers, and exhorting our respective turtles to hurry up and win the race. As events transpired, the laboratory director walked in, received a confession from the instigator, and following a short office visit let Draper know that he did not have

2012 Wikipedia

943. Ulcerative colitis (Full text)

be accompanied by different degrees of abdominal pain, from mild discomfort to painful bowel movements or painful abdominal cramping with bowel movements. Ulcerative colitis is associated with a general inflammatory process that can affect many parts of the body. Sometimes, these associated extra-intestinal symptoms are the initial signs of the disease, such as painful arthritic knees in teenagers, which also may be seen in adults. A diagnosis of UC may not occur until the onset of intestinal manifestations (...) (blue/purple) of the and architectural distortion of the crypts. The best test for diagnosis of ulcerative colitis remains . Full colonoscopy to the cecum and entry into the terminal ileum is attempted only if the diagnosis of UC is unclear. Otherwise, a flexible sigmoidoscopy is sufficient to support the diagnosis. The physician may elect to limit the extent of the exam if severe colitis is encountered to minimize the risk of of the colon. Endoscopic findings in ulcerative colitis include

2012 Wikipedia

944. Midwifery (Full text)

exam may be done to see if the mother's cervix is dilating. The and the mother discuss birthing options and write a birth care plan. Childbirth [ ] Labor and delivery [ ] An illustration of normal head-first presentation. The membranes have ruptured and the cervix is fully dilated. Newborn rests as caregiver checks breath sounds Main article: Midwives are qualified to assist with a normal vaginal delivery while more complicated deliveries are handled by a health care provider who has had further (...) a woman supported experience in the home to a medical intervention within the hospital. There are significant advantages to assuming an upright position in labor and birth, such as stronger and more efficient uterine contractions aiding cervical dilatation, increased pelvic inlet and outlet diameters and improved uterine contractility. Upright positions in the second stage include sitting, squatting, kneeling, and being on hands and knees. Postpartum period [ ] Main article: For women who have

2012 Wikipedia

945. Medicare (United States)

; the cost of annual physical exams for those not on health plans; and the costs related to basic Medicare's lifetime and per-incident limits. Medicare is divided into four Parts. Medicare Part A covers hospital (inpatient, formally admitted only), skilled nursing (only after being formally admitted to a hospital for three days and not for custodial care), and hospice services. Part B covers outpatient services including some providers' services while inpatient at a hospital, outpatient hospital charges (...) were , , , and and . The highest penalties on hospitals are charged after knee or hip replacements, $265,000 per excess readmission. The goals are to encourage better post-hospital care and more referrals to hospice and end-of-life care in lieu of treatment, while the effect is also to reduce coverage in hospitals that treat poor and frail patients. The total penalties for above-average readmissions in 2013 are $280 million, for 7,000 excess readmissions, or $40,000 for each readmission above

2012 Wikipedia

946. Medical radiography (Full text)

Medical radiography Radiography - Wikipedia Radiography From Wikipedia, the free encyclopedia (Redirected from ) For the medical specialty covering all imaging modes, see . For treatment using radiation, see . Radiography of the knee in a modern X-ray machine. System Subdivisions Interventional, Nuclear, Oncological Significant diseases , Significant tests , , , , , Specialist Radiography is an using , , or similar radiation to view the internal form of an object. To create the image, a beam (...) ), with advances in technology, levels of CT radiation dose and scan times have reduced . CT exams are generally short, most lasting only as long as a breath-hold, are also often used, depending on the tissues needing to be seen. Radiographers perform these examinations, sometimes in conjunction with a radiologist (for instance, when a radiologist performs a CT-guided ). Dual energy X-ray absorptiometry [ ] Main article: , or bone densitometry, is used primarily for tests. It is not projection radiography

2012 Wikipedia

947. Massage

is continuously increasing. In 2009, U.S. consumers spent between $4 and $6 billion on visits to massage therapists. In 2015, research estimates that massage therapy was a $12.1 billion industry. All but 6 States require massage therapists to be licensed, and licensure requires the applicant to receive training at an accredited school, and to pass a comprehensive exam. Those states that require licensure also typically require continuing education in massage techniques and in ethics. United Kingdom (...) to be helpful in reducing pain, , and improving function in patients with of the knee over a period of eight weeks. The development of Swedish massage is often inaccurately credited to , though the practitioner applied the French terms to name the basic strokes. The term "Swedish" massage is actually only recognized in English and Dutch speaking countries, and in Hungary. Elsewhere the style is referred to as "classic massage". Clinical studies report that Swedish Massage can effectively reduce low back

2012 Wikipedia

948. Beating heart cadaver (Full text)

manipulated. They also required that an electroencephalography ( ) show no signs of activity. The purpose of this report was to encourage physicians to distinguish brain death and irreversible coma from a where the patient still has some awareness and cycles through sleep and wakefulness. In 1971 a similar Minnesota criteria was published eliminating the EEG, repeating the exam after 12 hours, a severe lesion in the brain, and increasing the duration of the apnea test to four minutes rather than Harvard's (...) three minute guideline. Other slight changes in the next decades included the United Kingdom's decision to eliminate the repetition of the exam and change from a duration of the apnea test to specified levels of CO 2 in 1976. Later, in 1981 the President's Commission reinstated the apnea test and the repeat exam. In a study done in 1989, only 35% of 195 physicians and nurses involved in organ procurement polled knew brain death criteria. These were not the same nurses and physicians who diagnose

2012 Wikipedia

949. Biomedical engineering (Full text)

) or premarket notification (510k), a scientific review to ensure the device's safety and effectiveness, in addition to the general controls of Class I. Examples include replacement heart valves, hip and knee joint implants, silicone gel-filled breast implants, implanted cerebellar stimulators, implantable pacemaker pulse generators and endosseous (intra-bone) implants. Medical imaging [ ] Main article: Medical/biomedical imaging is a major segment of . This area deals with enabling clinicians to directly (...) , or Biomedical engineering can gain status through the . The Institution also runs the Engineering in Medicine and Health Division. The Institute of Physics and Engineering in Medicine (IPEM) has a panel for the accreditation of MSc courses in Biomedical Engineering and Chartered Engineering status can also be sought through IPEM. The – the first (and more general) of two licensure examinations for most U.S. jurisdictions—does now cover biology (although technically not BME). For the second exam, called

2012 Wikipedia

950. Bone

, a history and exam will be taken. Bones are then often imaged, called . This might include , , and other imaging such as a , which may be used to investigate cancer. Other tests such as a blood test for autoimmune markers may be taken, or a aspirate may be taken. Fractures [ ] used to identify possible after a knee injury. Main article: In normal bone, occur when there is significant force applied, or repetitive trauma over a long time. Fractures can also occur when a bone is weakened (...) immobile, then the joint is called a "suture". Development [ ] Endochondral ossification Section through a juvenile knee joint (rat) showing the cartilagineous growth plates The formation of bone is called . During the this occurs by two processes: and . [ ] Intramembranous ossification involves the formation of bone from whereas endochondral ossification involves the formation of bone from . Intramembranous ossification mainly occurs during formation of the flat bones of the but also the mandible

2012 Wikipedia

951. Orthopedic surgery (Full text)

derivative designs were the most-used systems in the world. This formed the basis for all modern hip implants. The hip replacement system (with a slightly different stem geometry) was developed at the same time. Since Charnley, there have been continuous improvements in the design and technique of (arthroplasty) with many contributors, including W. H. Harris, the son of R. I. Harris, whose team at Harvard pioneered uncemented arthroplasty techniques with the bone bonding directly to the implant. Knee (...) Surgery or the means that the orthopedic surgeon has met the specified educational, evaluation, and examination requirements of the Board. The process requires successful completion of a standardized written exam followed by an oral exam focused on the surgeon's clinical and surgical performance over a 6-month period. In Canada, the certifying organization is the ; in Australia and New Zealand it is the . In the United States, specialists in hand surgery and orthopedic sports medicine may obtain

2012 Wikipedia

952. Limp

. It most commonly presents with hip pain in males during puberty and is associated with . The majority of people affected have a painful limp and in half of cases both hips are affected. Nearly a quarter of people present with only knee pain. Treatment involves non-weight-bearing movement and surgery. If not identified early, or death of the head of the femur may occur. Other [ ] A non-painful limp may be due to a number of mechanical conditions including and leg length differences. Inflammatory (...) of the head of the femur which results in bone loss and deformity. It usually presents as a chronic condition. Neoplastic [ ] Cancers including , , and may result in a gradual onset of limping in children. It is often associated with night sweating, easy bruising, weight loss, and pain most prominent at night. Diagnostic approach [ ] The diagnosis of the cause of a limp is often made based on history, physical exam findings, laboratory tests, and radiological examination. If a limp is associated with pain

2012 Wikipedia

953. Disease registry

that can be defined according to certain rules and there is evidence that certain tests like retina exams, LDL levels, HgbA1c levels can correlate with quality of care in diabetes. Because of the diabetes impact, the New York City created a HbA1C Registry (NYCAR) to help health providers keep track of patients with diabetes. Another example of disease registry is the New York State CABG Registry that tracks all cardiac bypass surgery performed in the state of New York On a survey of 1040 US physician (...) and standardized by national organizations like the . Patient registries are particularly useful for evaluating the safety of products as well as the safety of drugs in specific populations. Medical devices registries [ ] Countries like Australia, Britain, Norway, Sweden, and America have national a that track patients with artificial joints. "The use of joint registries has proven beneficial abroad. In Australia, regulators use such data to force manufacturers to justify why poorly performing hips or knees

2012 Wikipedia

954. Appendicitis

being evaluated lies on her or his back with the hip and knee both flexed at ninety degrees. The examiner holds the person's ankle with one hand and knee with the other hand. The examiner rotates the hip by moving the person's ankle away from his or her body while allowing the knee to move only inward. A positive test is pain with internal rotation of the hip. , also known as "Obraztsova's sign", is right lower-quadrant pain that is produced with either the passive extension of the right hip (...) or ultrasound exam may be used to reduce the rate of negative appendectomy. Alvarado score Migratory right pain 1 point 1 point and 1 point Right iliac fossa 2 points 1 point 1 point High white blood cell count ( ) 2 points Shift to left (segmented ) 1 point Total score 10 points Pathology [ ] The definitive diagnosis is based on . The finding of appendicitis is infiltrate of the . Periappendicitis, of tissues around the appendix, is often found in conjunction with other abdominal pathology. of appendicitis

2012 Wikipedia

955. Lyme disease (Full text)

delusions, sometimes accompanied by a or derealization syndrome, where the patients begin to feel detached from themselves or from reality. A number of studies have found the causative agent of Lyme Borrelia burgdorferi in both the meninges and brains of people with neurological symptoms. Lyme arthritis usually affects the knees. In a minority of people, arthritis can occur in other joints, including the ankles, elbows, wrists, hips, and shoulders. Pain is often mild or moderate, usually with swelling (...) making a diagnosis of Lyme disease, health care providers should consider other diseases that may cause similar illnesses. Not all individuals infected with Lyme disease develop the characteristic bull's-eye rash, and many may not recall a tick bite. Because of the difficulty in Borrelia bacteria in the laboratory, diagnosis of Lyme disease is typically based on the clinical exam findings and a history of exposure to Lyme areas. The EM rash, which does not occur in all cases, is considered sufficient

2012 Wikipedia

956. Neurological examination (Full text)

is important, and an idea of how competent the patient is with various tasks and his/her level of impairment in carrying out these tasks should be obtained. The interval of a complaint is important as it can help aid the diagnosis. For example, disorders (such as strokes) occur very frequently over minutes or hours, whereas chronic disorders (such as Alzheimer's disease) occur over a matter of years. Carrying out a 'general' examination is just as important as the neurological exam, as it may lead to clues (...) against slight, moderate and strong resistance respectively. Muscle tone and signs of . Examination of Resting Abnormal movements Tone Rigidity Cogwheeling (abnormal tone suggestive of Parkinson's disease) Gegenhalten – is resistance to passive change, where the strength of antagonist muscles increases with increasing examiner force. More common in dementia. "strength 5/5 throughout, tone WNL" : masseter, biceps and triceps tendon, knee tendon, ankle jerk and (i.e., ). Globally, brisk reflexes suggest

2012 Wikipedia

957. Point of Care Ultrasound (US) Versus Detailed Radiology US for Deep Vein Thrombosis (DVT)

thrombosis ordered by the primary team. Criteria Inclusion Criteria: Male and female adults at least 18 years of age Duplex ultrasonography ordered by treating team Admission to the Medical, Cardiac, Burn, or Surgical intensive care units Exclusion Criteria: Patients less than 18 years of age Patients with a known current DVT patients on whom the exam cannot be performed (above the knee amputation, severe cellulitis of groin or popliteal fossa, hip or knee fracture) Contacts and Locations Go (...) physician performed ultrasound and formal duplex ultrasonography for detection of proximal deep vein thrombosis. [ Time Frame: 48 hours window from detailed US ] Secondary Outcome Measures : Subgroup analysis: location of thrombus (proximal or distal) [ Time Frame: 48 hours window from detailed US ] Subgroup analysis: number of days in the hospital prior to exam [ Time Frame: 48 hours window from detailed US ] Subgroup analysis: body mass index (BMI) [ Time Frame: 48 hours window from detailed US

2010 Clinical Trials

958. Safety, Tolerability and Pharmacokinetics of Single Dose Intravenous Moxifloxacin in Pediatric Patients

With Treatment Emergent Findings on Joint Assessment: Baseline [ Time Frame: Baseline ] Joint assessment included formal physical examination of all joints with special care and attention to the weight-bearing joints (such as, knees, hips, and ankles) and to the shoulder girdle. All joints were examined for pain/tenderness, evidence of inflammation (i.e., redness, warmth, deformity, swelling or ballotable fluid), loss of function (to the extent this could be assessed in younger children and infants), and any (...) restrictions to expected active/passive range of motion. An incidence count was reported as the number of subjects with at least one finding at baseline, regardless of side. Number of Subjects With Treatment Emergent Findings on Joint Assessment : At any Time During Treatment [ Time Frame: Day 1 up to Year 5 (follow-up) ] Joint assessment included formal physical examination of all joints with special care and attention to the weight-bearing joints (such as, knees, hips, and ankles) and to the shoulder

2010 Clinical Trials

959. Provant Therapy of Venous Stasis Ulcer Trial

. Target ulcer must be present for at least 6 weeks prior to randomization. Other ulcers close to the study ulcer are allowable and may be any size but should be greater than 2cm away from the study ulcer; no more than 4 ulcers total on the target limb are allowed. A duplex ultrasound study documenting venous disease must be performed within on year of study entry. The ultrasound exam should document either chronic occlusion of the target limb popliteal, femoral, or iliac veins or the vena cava (...) brachial artery systolic pressure determined with Doppler ultrasound. Any major surgery or trauma affecting the target limb such as tibial fracture, knee arthroplasty, endovascular or open arterial or venous surgery or femoral stenting within 180 days of randomization. Participation in any clinical trial involving therapy for wound healing within 30 days of randomization. Concurrent administration of systemic agents that influence wound healing such as prednisone or dexamethasone in any quantity

2010 Clinical Trials

960. Assessment of Near Infrared Spectroscopy as a Diagnostic Tool in Acute Compartment Syndrome

. If untreated, the results can be catastrophic with an insensate, contracted leg. Moreover, there is a high risk of subsequent infection and even amputation. The treatment for ACS, a four compartment fasciotomy, is aimed at releasing the pressure through two incisions from roughly the knee to the ankle. Often due to wound expansion, the incisions require multiple debridements and skin grafting to close. With fasciotomies, fractures are converted from closed to open injuries. When left open for many days (...) , vs. low-energy, a twisted ankle). Clinicians are left to attempt to interpret physical exam findings and readings from pressure monitors. Most importantly ACS is not an event, but a process that can manifest at multiple points after injury. The most accurate and effective method for diagnosing and appropriately treating ACS is serial examination over a course of hours to days. With this study, we hope to evaluate the NIRS device, which is non-invasive, as diagnostic tool in the evaluation

2010 Clinical Trials

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