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McMurray Test

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281. Population Approaches to Improve Diet, Physical Activity, and Smoking Habits Full Text available with Trip Pro

simultaneously. The Stanford Five-City Project tested a 5-year community-based program that incorporated behavior change theory (social learning theory, a communication-behavior change model), community organization principles, and social marketing methods. After 3 to 5 years of intervention, compared with controls, the intervention communities saw improvements in several cardiovascular risk factors, including lower blood cholesterol, blood pressure, resting heart rate, weight gain, and smoking prevalence (...) cardiovascular risk factors and behaviors simultaneously have been less successful, which suggests the importance of focused messages for the target audience. This is a major premise of social marketing, which uses a consumer orientation to behavior change: Incorporation of research from the target population, testing of different strategies and channels of delivery, and integration of marketing principles (eg, product, place, promotion) into the intervention. Media and education have also been prominently

2012 American Heart Association

282. Meniscal tear presentation, diagnosis and management

be significant quadriceps wasting. McMurray (Figure 1) and Apley tests (Figure 2) are often positive, although these are specific but not sensitive – specificity being 57–98% and 80–99%, and sensitivity being 10–66% and 16–58% respectively. 2,9 The most useful clinical test for meniscal injury is the Thessaly test, which is demonstrated in Figure 3 . Although rarely taught and poorly utilised, recent validation demonstrated a sensitivity of 90%, and specificity of 98% in detecting meniscal injury. 10 (...) do not rapidly improve. Figure 1. McMurray test: The patient lies supine on the bed with the hip and knee both flexed. With the foot as close to the hip as possible, the clinician holds the knee joint (with fingers along the joint line) with one hand, and the other hand rotates the tibia internally and externally while extending and flexing the knee. If the test is positive (suggesting a meniscal tear), the patient will feel pain and the clinician will feel and/or hear meniscal movement when

2012 Clinical Practice Guidelines Portal

283. FA Clinical Outcome Measures

to Primary Outcome Measures : Friedreich Ataxia Rating Scale [ Time Frame: once every 1 year ] rating scale based on clinical neurologic examination Secondary Outcome Measures : 9-hole peg test [ Time Frame: once every 1 year ] timed test of fine motor skills performed as a set of four trials (two trials per hand), for patients with FA who are able to complete this testing timed 25 foot walk [ Time Frame: once every 1 year ] timed 25 foot walk is performed twice for patients with FA who are able (...) to complete this testing. Assistive devices such as canes, service dogs, walkers, or crutches are permitted. Vision assessment [ Time Frame: once every 1 year ] High and low contrast visual acuity tested on patients with FA who are able to perform this test. Glasses or contact lenses are permitted. Quality of Life Questionnaires [ Time Frame: once every 1 year ] a set of quality of life questionnaires is administered for study participants with Friedreich ataxia. Questionnaires include items

2017 Clinical Trials

284. A Case of Infrapatellar Fat Pad Ganglion of the Knee Full Text available with Trip Pro

A Case of Infrapatellar Fat Pad Ganglion of the Knee A ganglion cyst can induce symptoms around the knee and should be considered as an intra-articular mass in differential diagnosis.A 22-year-old female presented with a persistent medial knee joint pain in her left knee for 2 years. There was soft tissue swelling on the anteromedial aspect of the infrapatellar region on her left knee. Lachman and McMurray tests were negative. MRI showed a multilobular cyst in the infrapatellar fat pad with T1

2017 The open orthopaedics journal

285. Relationship between Clinical, MRI, and Arthroscopic Findings: A Guide to Correct Diagnosis of Meniscal Tears Full Text available with Trip Pro

a careful examination, to bypass MRI and perform directly arthroscopy in suspected cases. Methods  A total of 80 patients with a history of knee trauma, preoperative RX, and MRI underwent arthroscopy over an 8-month period at our department. All patients had a clinical examination performed by an experienced knee surgeon. These examiners evaluated and recorded the results of three tests: medial and lateral joint line tenderness test, McMurray's test, and Apley's test. The injury was classified (...) as a meniscal tear if there were at least two positive tests. Finally, using the arthroscopic findings as the gold standard, sensibility, specificity, accuracy, positive and negative predictive values of clinical examination, and MRI were evaluated and compared. Results  Clinical examination performed by an experienced knee surgeon reported better sensitivity (91 vs. 85%), specificity (87 vs. 75%), accuracy (90 vs. 82%), positive predictive value (94 vs. 88%), and negative predictive value (81 vs. 71%) than

2017 Joints

286. Occupational Therapy for Adults Undergoing Total Hip Replacement

from both the literature (McMurray et al 2000, Drummond et al 2012), and from expert practitioners involved in the College of Occupational Therapists Specialist Section – Trauma and Orthopaedics, has, however, con?rmed that differences exist in practice across the UK in areas which include pre- operative assessment and education processes, use of hip precautions and equipment provision. The number of service users undergoing total hip replacement in the UK is high. This demand for orthopaedic

2012 Publication 1554

287. Genetics of Colorectal Cancer (PDQ®): Health Professional Version

% or greater on MMRpro and MMRpredict are recommended for genetic evaluation referral and testing. Associated Genes and Syndromes Hereditary CRC has two well-described forms: (1) polyposis (including and (AFAP), which are caused by pathogenic variants in the gene; and , which is caused by pathogenic variants in the MUTYH gene); and (2) (often referred to as hereditary nonpolyposis colorectal cancer), which is caused by germline pathogenic variants in DNA MMR genes ( , , , and ) and . Other CRC syndromes (...) that all individuals with newly diagnosed CRC are evaluated for Lynch syndrome through molecular diagnostic tumor testing assessing MMR deficiency. A is supported, in which all CRC cases are evaluated regardless of age at diagnosis or fulfillment of existing clinical criteria for Lynch syndrome. A more cost-effective approach has been reported whereby all patients aged 70 years or younger with CRC and older patients who meet the revised Bethesda guidelines are tested for Lynch syndrome. Tumor

2016 PDQ - NCI's Comprehensive Cancer Database

288. Colorectal Cancer Prevention (PDQ®): Health Professional Version

or surveillance could counterbalance long-term risks such as gastrointestinal ulceration and hemorrhagic stroke for the average-risk individual.[ ] Calcium supplements A randomized placebo-controlled trial tested the effect of calcium supplementation (3 g calcium carbonate daily [1,200 mg elemental calcium]) on the risk of recurrent adenoma.[ ] The primary endpoint was the proportion of patients (72% of whom were male) in whom at least one adenoma was detected following a first and/or second follow-up

2016 PDQ - NCI's Comprehensive Cancer Database

289. Heart Failure (Multi-Disciplinary Community Care) Clinics Field Evaluation

Analytic Plan and Study Definitions 25 Statistical Analyses 26 Institutional Review Board 26 Results 27 Baseline Characteristics of HF patients 27 Clinic Visits and Diagnostic Tests 27 Medication Use 27 Comparison of Early vs. Recent Cohorts 28 Target Doses of ACEi/ARB and ß-blockers 28 Predictors of ACEi/ARB and ß-blocker use 28 Discussion 30 Table 1: Baseline Characteristics 32 Table 2: Diagnostic Test Performed over 1 year of chart abstraction 33 Table 3: Medication ever prescribed 34 Table 4 (...) Parameter PERSONEL Mean number of Physicians 4.7 (1-8)* % cardiologist 80.6 % internists 22.6 % family physicians 9.7 % Heart failure training 80.6 Mean Number of Nurses 2.0 (1-6)* LOCATION % Academic 25.8 % Community Based 74.2 Mean Annual Total Visits 1020 (200-1479)* Mean Annual Total New Patients 139 (25-128)* % Access to Onsite Echocardiography 80.6 % Access to Onsite Nuclear Cardiology Testing 58.1 % Access to Onsite Angiography 38.7 % Access to Onsite Exercise Stress Testing 77.4 Mean Exam Rooms

2011 Health Quality Ontario

290. Acute Coronary Syndromes (ACS) in patients presenting without persistent ST-segment elevation

. There is no fundamental difference between troponin T and troponin I. Differences between study results are explained by varying inclusion criteria, variances in sampling patterns, and the use of assays with different diagnostic cut-offs. In the clinical setting, a test with high ability to rule out (negative predictive value) and correctly diagnose ACS (positive predictive value) is of paramount interest. The diagnostic cut-off for MI is de?ned as a cardiac troponin measurement exceeding the 99th per- centile (...) or ultrasensitive assays have been introduced that have a 10- to 100-fold lower limit of detection and ful?l the require- ments of analytical precision. Therefore, MI can now be detected more frequently and earlier in patients presenting with chest pain. 20,21 The superiority of these new assays, particularly in the early phase of pain onset, was prospectively demonstrated. 20,21 The negative predictive value for MI with a single test on admission is .95% and thereby at least as high as with previous assays

2011 European Society of Cardiology

291. Guidelines for the management of dyslipidaemias

Gotcheva (Bulgaria), Kathryn Grif?th (UK), Guido Francesco Guida (Italy), Sadi Gulec (Turkey), Yaakov Henkin (Israel), Kurt Huber (Austria), Y. Antero Kesaniemi (Finland), John Lekakis (Greece), Athanasios J. Manolis (Greece), Pedro Marques-Vidal (Switzerland), Luis Masana (Spain), John McMurray (UK), Miguel Mendes (Portugal), Zurab Pagava (Georgia), Terje Pedersen (Norway), Eva Prescott (Denmark), Quite ´ria Rato (Portugal), Giuseppe Rosano (Italy), Susana Sans (Spain), Anton Stalenhoef (...) with a 10 year risk of CV death of =5% has an increased risk. The reasons for retaining a system that estimates fatal as opposed to total fatal+ non-fatal events are that non-fatal events are dependent on de?nition, developments in diagnostic tests,andmethodsofascertainment,allofwhich canvary, resulting in very variable multipliers to convert fatal to total events. In addition, total event charts, in contrast to those based on mor- tality, cannot easily be re-calibrated to suit different populations

2011 European Society of Cardiology

292. Cardiovascular Diseases during Pregnancy

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3150 2. General considerations . . . . . . . . . . . . . . . . . . . . . . . . . .3151 2.1. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3151 2.2. Methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3151 2.3. Epidemiology . . . . . . . . . . . . . . . . . . . . . . . . . . . .3151 2.4. Haemodynamic, haemostatic, and metabolic alterations during pregnancy . . . . . . . . . . . . . . . . . . . . . . . . . .3151 2.5. Genetic testing and counselling (...) and resorption of leg oedema. In conclusion, the physiological adaptations to pregnancy in?u- ence the evaluation and interpretation of cardiac function and clini- cal status. 2.5 Genetic testing and counselling An important aspect concerning the care of young women with CVD is the consultation about the risk of inheritance of cardiac defects for their descendants. The risk is raised signi?cantly in com- parison with parents without CVD where the risk is 1%. In addition, there are large differences between

2011 European Society of Cardiology

293. Treatment of Anemia in Patients with Heart Disease

numbers with CHF; type and severity of CHF not reported. Venous thrombosis (–) Moderate Based on two large trials including large numbers with CHF; type and severity of CHF not reported; effects of more moderate hemoglobin targets not tested. Hypertension, cerebrovascular events (–) Low Based on one large trial including large numbers with CHF, but CHF subgroup data not separately reported for this outcome. Iron All outcomes (0) No evidence. Blood transfusions All outcomes (0) No evidence (...) , most commonly NYHA class, 6-minute walk test), quality of life, cardiovascular events (myocardial infarction, heart failure exacerbation, need for revascularization) Setting: Inpatient or outpatient Figure 1 illustrates the analytic framework that guided our review and synthesis.8 Treatment of Anemia in Patients with Heart Disease: A Systematic Review Evidence-based Synthesis Program Figure 1. Analytic Framework Patients with CHF and/or CHD AND Anemia and/or Iron Deficiency Treatment harms

2011 Veterans Affairs Evidence-based Synthesis Program Reports

294. Secondary Prevention For Patients With Coronary and Other Atherosclerotic Vascular Disease: 2011 Guideline Update

patients, risk assessment with a physical activity history and/or an exercise test is recommended to guide prognosis and prescription (47–52,58). (Level of Evidence: B) 3. The clinician should counsel patients to report and be evaluated for symptoms related to exercise. (Level of Evidence: C) Class IIa 1. It is reasonable for the clinician to recommend complementary resistance training at least 2 days per week (59). (Level of Evidence: C) Weight management Class I Goals: 1. Body mass index and/or waist (...) . For patients with triglyceride levels200 mg/dL, non–high-density lipo- protein cholesterol values should be used as a guide to therapy. Although no studies have directly tested treatment to target strategies, the target LDL-C and non–HDL-C levels are derived from several randomized controlled trials where the LDL-C levels achieved for patients showing bene?t are used to suggest targets. Thus, references for the studies from which targets are derived are listed and targets are considered as level

2011 American College of Cardiology

295. Treatment and recommendations for homeless people with Chronic Non-Malignant Pain

Assessment, Screening & Diagnostic Testing 13 PLAN & MANAGEMENT Plan of Care 18 Education, Self-Management 20 Treatment, Management 24 Associated Problems, Complications 30 Follow-up 34 MODEL OF CARE Service Delivery Design 36 Outreach and Engagement 40 Standards of Care 42 Transitions in Care 43 CASE STUDIES Integrated Group Medical Visits for Challenging Patients 44 Managing Chronic Pain with Comorbid Addiction 45 SOURCES & RESOURCES Primary Sources 46 References on Homeless/Underserved Populations 46 (...) exams (as tolerated), if needed. Look for evidence of occult alcoholism or addiction. ? Practice Trauma-Informed Care during the physical examination and in all patient encounters, recognizing that individuals who are homeless are likely to have experienced some form of previous trauma. ASSESSMENT, SCREENING & DIAGNOSTIC TESTING ? Assess every chronic pain patient for substance use and mental health issues. Based on prevalence of behavioral health issues in the patient population served as well

2011 National Health Care for the Homeless Council

296. 2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease Full Text available with Trip Pro

With Chest Pain: Recommendations. . . . . . . .e367 2.1.2. History. . . . . . . . . . . . . . . . . . . . . . . . . .e367 2.1.3. Physical Examination. . . . . . . . . . . . . . .e368 2.1.4. Electrocardiography. . . . . . . . . . . . . . . .e368 2.1.4.1. Resting Electrocardiography to Assess Risk: Recommendation. . . . . . . . . . .e369 2.1.5. Differential Diagnosis. . . . . . . . . . . . . .e370 2.1.6. Developing the Probability Estimate. . .e370 2.2. Noninvasive Testing for Diagnosis of IHD. . . .e371 (...) 2.2.1. Approach to the Selection of Diagnostic Tests to Diagnose SIHD. . . .e371 2.2.1.1. Assessing Diagnostic Test Characteristics. . . . . . . . . .e372 2.2.1.2. Safety and Other Considerations Potentially Affecting Test Selection. . . . . .e373 2.2.1.3. Exercise Versus Pharmacological Testing. . . . . .e374 2.2.1.4. Concomitant Diagnosis of SIHD and Assessment of Risk. . . . . . . . . . . . . . . . . . .e374 2.2.1.5. Cost-Effectiveness. . . . . . . . . . .e375 2.2.2. Stress Testing and Advanced

2011 American Heart Association

297. 2011 update to NHFA and CSANZ guidelines for the prevention, detection and management of chronic heart failure in Australia

% of cases). Diagnosis is based on clinical features, chest X-ray and objective measurement of ventricular function (e.g. echocardiography). Plasma levels of B-type natriuretic peptide (BNP) may have a role in diagnosis, primarily as a test for exclusion. Diagnosis may be strengthened by improvement in symptoms in response to treatment. Management involves prevention, early detection, slowing of disease progression, relief of symptoms, minimisation of exacerbations, and prolongation of survival. Key (...) structural or functional cardiac disorder that impairs the ability of the ventricle to fill with or eject blood. European Task Force on Heart Failure, 2005 2 A syndrome in which the patients should have the following features: symptoms of heart failure, typically breathlessness or fatigue, either at rest or during exertion, or ankle swelling and objective evidence of cardiac dysfunction at rest. Adapted from Byrne J, Davie AP and McMurray JJV, 2004. 10 CHF is a complex clinical syndrome with typical

2011 Clinical Practice Guidelines Portal

298. Guidelines for the prevention, detection and management of chronic heart failure (updated October 2011)

, chest X-ray and objective measurement of ventricular function (e.g. echocardiography). Plasma levels of B-type natriuretic peptide (BNP) may have a role in diagnosis, primarily as a test for exclusion. Diagnosis may be strengthened by improvement in symptoms in response to treatment. Management involves prevention, early detection, slowing of disease progression, relief of symptoms, minimisation of exacerbations, and prolongation of survival. Key therapeutic approaches or considerations include (...) structural or functional cardiac disorder that impairs the ability of the ventricle to fill with or eject blood. European Task Force on Heart Failure, 2005 2 A syndrome in which the patients should have the following features: symptoms of heart failure, typically breathlessness or fatigue, either at rest or during exertion, or ankle swelling and objective evidence of cardiac dysfunction at rest. Adapted from Byrne J, Davie AP and McMurray JJV, 2004. 10 CHF is a complex clinical syndrome with typical

2011 Clinical Practice Guidelines Portal

299. Newly learned word forms are abstract and integrated immediately after acquisition Full Text available with Trip Pro

). Recently, however, Kapnoula, Packard, Gupta, and McMurray, (Cognition, 134, 85-99, 2015) showed that interference can be observed immediately after a word is first learned, implying very rapid integration of new words into the lexicon. It is an open question whether these kinds of effects derive from episodic traces of novel words or from more abstract and lexicalized representations. Here we addressed this question by testing inhibition for newly learned words using training and test stimuli presented (...) in different talker voices. During training, participants were exposed to a set of nonwords spoken by a female speaker. Immediately after training, we assessed the ability of the novel word forms to inhibit familiar words, using a variant of the visual world paradigm. Crucially, the test items were produced by a male speaker. An analysis of fixations showed that even with a change in voice, newly learned words interfered with the recognition of similar known words. These findings show that lexical

2016 Psychonomic bulletin & review

300. Risk factors for lesions of the knee menisci among workers in South Korea’s national parks Full Text available with Trip Pro

Risk factors for lesions of the knee menisci among workers in South Korea’s national parks This study was designed to investigate the prevalence of the menisci lesions in national park workers and work factors affecting this prevalence.The study subjects were 698 workers who worked in 20 Korean national parks in 2014. An orthopedist visited each national park and performed physical examinations. Knee MRI was performed if the McMurray test or Apley test was positive and there was a complaint (...) of pain in knee area. An orthopedist and a radiologist respectively read these images of the menisci using a grading system based on the MRI signals. To calculate the cumulative intensity of trekking of the workers, the mean trail distance, the difficulty of the trail, the tenure at each national parks, and the number of treks per month for each worker from the start of work until the present were investigated. Chi-square tests was performed to see if there were differences in the menisci lesions

2016 Annals of occupational and environmental medicine

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