auscultation

Bacterial endocarditis (BE) is the most common valvular disease in cattle but diagnosis in the living animal remains a challenge for clinicians. The objective of the study was to report evidence-based veterinary medicine data concerning the clinical presentation and results of ancillary tests of necropsy-confirmed cases of bovine BE. A systematic review and subsequent meta-analysis was performed using Medline and CAB abstracts of every article on bovine BE published in English, Japanese, German and French. The clinical criteria that were specifically assessed for diagnosis of BE were: tachycardia, heart murmur, signs of congestive heart failure, presence of fever, evidence of lameness/polyarthritis, one or more positive blood cultures and positive echocardiograms for BE. A total of 34 studies (460 cases of BE) satisfied the inclusion criteria for the systematic review. The sensitivity (Se), specificity (Sp) and 95% confidence interval (CI) were obtained using a random-effect meta-an...

The aim of this study was to evaluate the capacity of a traditional stethoscope versus an electronically amplified one (expected to reduce background and ambient noise) to assess heart and respiratory sounds during medical transport. It was a prospective, double-blinded, randomized performed study. One traditional stethoscope (Littmann Cardiology III; 3M, St Paul, MN) and 1 electronically amplified stethoscope (Littmann 3200, 3M) were used for our tests. Heart and lung auscultation during real medical evacuations aboard a medically configured Falcon 50 aircrafts were studied. The quality of auscultation was ranged using a numeric rating scale from 0 to 10 (0 corresponding to "I hear nothing" and 10 to "I hear perfectly"). Data collected were compared using a t-test for paired values. A total of 40 comparative evaluations were performed. For cardiac auscultation, the value of the rating scale was 4.53 ± 1.91 and 7.18 ± 1.88 for the traditional and amplified stethoscope, respectively (paired t-test: P < .0001). For respiratory sounds, quality of auscultation was estimated at 3.1 ± 1.95 for a traditional stethoscope and 5.10 ± 2.13 for the amplified one (paired t-test: P < .0001). This study showed that practitioners would be better helped in hearing cardiac and respiratory sounds with an electronically amplified stethoscope than with a traditional one during air medical transport in a medically configured Falcon 50 aircraft.

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.

Auscultation is an important part of the clinical examination of different lung diseases. Objective analysis of lung sounds based on underlying characteristics and its subsequent automatic interpretations may help a clinical practice. We collected the breath sounds from 8 normal subjects and 20 diffuse parenchymal lung disease (DPLD) patients using a newly developed instrument and then filtered off the heart sounds using a novel technology. The collected sounds were thereafter analysed digitally on several characteristics as dynamical complexity, texture information and regularity index to find and define their unique digital signatures for differentiating normality and abnormality. For convenience of testing, these characteristic signatures of normal and DPLD lung sounds were transformed into coloured visual representations. The predictive power of these images has been validated by six independent observers that include three physicians. The proposed method gives a classification ...

Auscultation training devices are needed by teachers and students in health schools to practice auscultation techniques. In this paper, a low-cost IoTbased auscultation training device has been developed using NodeMCU, four proximity sensors, metal as a stethoscope, a switch, an android smartphone, an earphone, and a phantom doll. The message queuing telemetry transport (MQTT) protocol has been used for data communication between NodeMCU and smartphones, therefore an auscultation training hardware can be used by many students who have auscultation training application on their smartphones that subscribe to topics. The results showed that an auscultation training device was able to detect a stethoscope. Auscultation training application on a smartphone successfully plays normal and abnormal breathing sounds based on subscribed topics. With a production cost of less than 15 USD, we offer an inexpensive IoT-based auscultation training device.

The stethoscope has been used for many years, and has been very effective to diagnose certain cardiologic and pulmonologic sounds. For many years healthcare professionals would listen quietly to patients internal organs so they could diagnose from specific sounds of such internal organs. The objective is to develop a Peripheral Interface Controller based digital Stethoscope to capture the heart sound. The proposed designed device consists of following hardware stages: Front-end pickup circuitry, PIC18F2550 microcontroller, (128×64) graphic LCD and a Serial EEPROM. The captured data can be sent to PC for software analysis using LabVEIW. A digital stethoscope would help healthcare professional record their findings on a Serial EEPROM. Once the data is stored, the healthcare professionals can hear and plot the graph. This would be quick and more effective since there is a visual and audio representation to diagnose such cardiologic sounds.

Purpose: Sedation is becoming more commonplace for pediatric patients undergoing minor procedures. Fortunately, electronic monitors have contributed to a reduction in the associated respiratory adverse events (RAEs). To test the hypothesis that adding the pretracheal stethoscope (PTS) to standard monitoring methods (SMMs) may improve RAE detection in sedated pediatric dental patients, the frequency of RAEs detected by SMMs (i.e. visual observation, capnography, and pulse oximetry) was compared to that detected by SMMs alongside continuous PTS auscultation. Study design: A prospective, randomised, controlled trial was performed with 100 pediatric patient participants of ASA≤2, who were scheduled to receive dental treatment under 0.75 mg/kg and oxygen. Patients were randomised into Groups A (n=50; SMMs) and B (n=50; SMMs+PTS). Inclusion criteria were behavioral management problems and intolerance to dental treatment despite behavioral management techniques or nitrous oxide administrat...

A prospective analysis of 100 successive intubations with Robertshaw tubes in patients submitted for routine thoracic surgery is presented. Clinical guidelines for intubation were used as the protocol. Tube position was judged on clinical assessment only and not ...

The safety of a dam is the result of a series of factors, including structural, geotechnical, hydraulic, operational and environmental aspects. In Brazil, Law No. 12.334 of September 2010 establishes the National Dam Safety Policy, which requires safety reports and monitoring inspections for existing dams. The inspection comprises a set of devices installed on the dam, which are used to assess the structural behavior based on performance parameters of the structure, such as displacements, flows, stresses, slopes and others. Dam auscultation procedures, historically, have been performed since the 1950s. Since then, there have been significant advances in instrumentation and dam auscultation methods. This work presents a theoretical approach on technical and scientific aspects of dams in Brazil, based on a state-of-the-art literature review, involving auscultation of dams in the context of design codes, concepts, instrumentation, safety, procedures and monitoring methods.

Despite wide use of systems to record jaw motion with six degrees of freedom, most studies have analyzed only the movement of a single mandibular point. The finite helical axis (FHA) is a mathematical model which can be used to describe comprehensively the movements of a rigid body. The aim of this investigation was to describe the FHA of the mandible during habitual jaw movements. Thirty subjects (13 females, 17 males; mean age, 26 years; range, 18 to 34 years) without myoarthropathies of the masticatory system participated in the study. Opening and closing movements, performed at 1-Hz frequency, were recorded with the optoelectronic system Jaws-3D. Three opening and closing movements were recorded from the right side and three from the left side of the jaw. The movement data were low-pass-filtered for noise reduction prior to the computation of the finite helical axis by means of a software program developed in our laboratory. The following parameters were calculated: the rotation...

Aims: Auscultation is a straight forward and inexpensive method for the preliminary diagnosis of heart valve disease. However, many valve diseases are clinically silent and therefore echocardiography may be the preferred option. In this prospective study we aimed to investigate the sensitivity of auscultation in patients with mitral and aortic valve
disease in comparison to Doppler echocardiography.
Methods: 300 consecutive patients with heart valve disease who attended the echocardiography department at Erbil Cardiac Centre between May 2015 and February 2016 were included in this study. Patients were excluded if they were under 15 years of age, had
poor window echocardiography, had prosthetic aortic and/or mitral valves, had a history of infective endocarditis, were pregnant or had congenital heart diseases. All of the included patients underwent cardiac auscultation of the mitral and aortic valve, which was carried out by 2 experienced cardiologists. All of these patients were then investigated
by transthoracic echocardiography.
Results: 215 mitral valve lesions and 122 aortic valve lesions were detected by echocardiography. The most common lesion detected was mitral regurgitation followed by aortic regurgitation, aortic stenosis and mitral stenosis. Auscultation was only able to detect 51.6% of the mitral valve lesions and 56.6% of the aortic valve lesions. There was a significant association between inaudible murmurs and mild valve lesions on echocardiography (p = 0.001) and between inaudible murmurs and systolic dysfunction as identified by echocardiography (p = 0.001).
Conclusions: Approximately half of the valve diseases detected by echocardiography were silent clinically.

The detection of swallowing events by acoustic means represents an important tool to assess and diagnose swallowing disorders as well as to objectively monitor ingestive behavior of individuals. Acoustic sensors used to register swallowing sounds may also capture sound artifacts arising from intrinsic speech and external noise affecting the detection. In this paper we tested if subsonic frequencies are less prone to artifacts from speech, chewing and other intrinsic sounds than sonic frequencies. A simple method using a throat and an ambient microphone was employed to compare the swallowing detection accuracy by acoustic signals acquired in the sonic (20-2500 Hz) and subsonic (≤ 5 Hz) ranges. Averaged recall values were higher than 85% for both ranges. However, averaged precision values of 50% for subsonic frequencies and of 42% for sonic frequencies were caused by a high number of false positives. These results indicated no significant difference between averaged precision values w...

Aspiration, where food or liquid is allowed to enter the larynx during a swallow, is recognized as the most clinically salient feature of oropharyngeal dysphagia. This event can lead to short-term harm via airway obstruction or more long-term effects such as pneumonia. In order to non-invasively identify this event using high resolution cervical auscultation there is a need to characterize cervical auscultation signals from subjects with dysphagia who aspirate. In this study, we collected swallowing sound and vibration data from 76 adults (50 men, 26 women, mean age 62) who underwent a routine videofluoroscopy swallowing examination. The analysis was limited to swallows of liquid with either thin (<5 cps) or viscous (≈300 cps) consistency and was divided into those with deep laryngeal penetration or aspiration (unsafe airway protection), and those with either shallow or no laryngeal penetration (safe airway protection), using a standardized scale. After calculating a selection of...

Cigarette smoking is often associated with the development of several respiratory diseases however, if diagnosed early, the changes in the lung tissue caused by smoking may be reversible. Computerised respiratory sounds have shown to be sensitive to detect changes within the lung tissue before any other measure, however it is unknown if it is able to detect changes in the lungs of healthy smokers. This study investigated the differences between computerised respiratory sounds of healthy smokers and non-smokers. Healthy smokers and non-smokers were recruited from a university campus. Respiratory sounds were recorded simultaneously at 6 chest locations (right and left anterior, lateral and posterior) using air-coupled electret microphones. Airflow (1.0-1.5 l/s) was recorded with a pneumotachograph. Breathing phases were detected using airflow signals and respiratory sounds with validated algorithms. Forty-four participants were enrolled: 18 smokers (mean age 26.2, SD = 7 years; mean F...

Benefits of listening to music with emotional attachment while recovering from a cerebral ischemic event have been reported. To develop a better understanding of the effects of music listening on the human brain, an algorithm for the graph-theoretical analysis of functional magnetic resonance imaging (fMRI) data was developed. From BOLD data of two paradigms (block-design, first piece: music without emotional attachment, additional visual guidance by a moving cursor in the score sheet; second piece: music with emotional attachment), network graphs were constructed with correlations between signal time courses as edge weights. Functional subunits in these graphs were identified with the MCODE clustering algorithm and mapped back into anatomical space using AFNI. Emotional centers including the right amygdala and bilateral insula were activated by the second piece (emotional attachment) but not by the first piece. Network clustering analysis revealed two separate networks of small-wor...