جستجوی مقالات مرتبط با کلیدواژه « auscultation » در نشریات گروه « پزشکی »

 In thoracic surgeries requiring thoracotomy incisions, correct positioning of the double-lumen endotracheal tube (DLT) is mandatory. After the pandemic of novel COVID-19, using simple, noninvasive technology such as lung ultrasound (LUS) can be important in avoiding the possibility of spreading infectious diseases or contagious infections that can follow using fiberoptic bronchoscopy (FOB).

 We aimed to assess the accuracy of auscultation and LUS in relation to FOB in the assessment of DLT placement and to identify the possibility of using LUS as an alternative to FOB during DLT insertion.

 This prospective cohort study was conducted according to STARD guidelines; enrolled 120 cases requiring DLT intubation. After DLT insertion, all patients were examined by stethoscope, then by LUS for determination of DLT position, and then confirmed by FOB in the same patient.

 Three patients dropped out due to failed intubation, and only 117 cases were analyzed. Time was significantly longer for LUS than for auscultation and FOB and was insignificantly different between auscultation and FOB. Auscultation had 76.14% sensitivity, 34.48% specificity, and 65.81% accuracy in the determination of correct DLT placement. LUS had 92.05% sensitivity, 79.31% specificity, and 88.89% accuracy in detecting correct DLT placement. There was substantial agreement between LUS and FOB (κ = 0.705) and poor agreement between auscultation and FOB (κ = 0.104).

 LUS can be used as a simple, noninvasive tool for detecting DLT placement with a substantial agreement with FOB.

Our goal was to compare two common methods including auscultation and Fiber-Optic Bronchoscopy (FOB) in confirming the correct placement of Double-Lumen Tube (DLT). Seventy six patients were enrolled. After DLT insertion, clinical verification was made by auscultation, then FOB was applied. At lateral decubitus, the position of DLT was rechecked by auscultation, and then by FOB. The incorrect position including malposition and misplacement were compared between two routine methods of auscultation and FOB. After blind intubation, 21.1% of DLTs were considered to be in an incorrect position. Meanwhile, FOB showed that 46.1% of DLTs were not placed correctly. Among all the patients, 53.9% of DLTs were in the optimal position. Misplacement was diagnosed in 35.5% and malposition in 10.5% of the patients. After positioning to the lateral decubitus, using auscultation, we found that 5.3% of tubes were dislocated, but according to FOB, it was 10.5%. The agreement coefficient between auscultation and FOB was 0.42 in the supine position and 0.64 in lateral position. Our results showed that although FOB needs more time to check the position of DLT, it should be used to confirm the exact position of DLT.

Various methods are used in order to describe the heart rate patterns of the fetus. The use of electronic monitoring during labor is widely accepted today. The aim of this study was to compare the neonatal outcomes of continuous Fetal Heart Rate (FHR) monitoring to intermittent auscultation among low-risk pregnant women during labor. This randomized clinical trial was conducted among 900 low-risk pregnant women who met inclusion criteria and were admitted to maternity wards of academic hospitals of Mashhad University of Medical Sciences for labor. They were randomly divided into two groups: the intermittent auscultation group and the Continuous FHR monitoring group. The pregnancy and neonatal outcomes were compared in two groups; data were processed in SPSS16 software. P less than 0.05 was considered as significant level. In this study, the first and fifth minutes Apgar scores, the rate of NICU admission, advance resuscitation requirement, neonatal seizure incidence, and the neonatal or fetal death did not differ significantly between two groups (P>0.05). In the Continues monitoring group, the rate of cesarean section due to fetal distress and operative vaginal delivery was significantly higher rather than the other group (P=0.001). The results of this study showed that continuous FHR monitoring in low-risk pregnancies during labor increases the risk of cesarean and instrumental delivery without improving neonatal outcomes.

Hypotension and hypertension have the potential ability to injure the vital organs. Controlling blood pressure is necessary to stabilize the patient's hemodynamic situation. There are different blood pressure measurement methods such as invasive blood pressure measurement (IBP), noninvasive blood pressure measurement (NIBP) and auscultatory method. This cross-sectional study was conducted on 20 inpatients of angiography ward of Sina hospital, Isfahan, Iran. The measurement accuracy of IBP, NIBP and auscultatory method compared and the effective parameters in each technique discussed. The mean error and standard deviation of IBP and oscillometric in all patients was -4.06±8.9 for MAP, -3.64±10.3for systolic and -4.22±4.9 for diastolic. The mean error and standard deviation of oscillometric and auscultatory for all patients was -1.73±6.5 in systolic pressure and 0.42±4 in diastolic pressure. Based on gender, systolic pressure error in men was -3.3±4.2 and -0.78±3.6 in women; diastolic pressure error in men was -4.37±9.5 and -4.37±8.9 in women and MAP error reported -4.2±8.57 and -1.2±8.17 in men and women respectively. Findings showed that in the range of normal pressure and prehypertension, the accuracy of IBP, NIBP and auscultatory method was nearly the same but for hypertension grade 1 and 2, only the mean error and standard deviation of MAP is acceptable. Considering the effect of gender on blood pressure manifest that the error of systolic pressure, diastolic pressure and MAP for women is less than men.

Intelligent electronic stethoscopes and computer-aided auscultation systems have highlighted a new era in cardiac auscultation in children. Several collaborative multidisciplinary researches in this field are performed by physicians and computer specialists. Recently, a novel medical software device, Automated Auscultation Diagnosis Device (AADD), has been reported with intelligent diagnosing ability to differentiate cardiac murmur from breath sounds in children with normal and abnormal hearts due to congenital heart disease. The aim of this study is to determine efficiency, sensitivity and specificity of the diagnoses made by this AADD in children with and without cardiac disease. We performed a cross-sectional study to determine efficiency, sensitivity and specificity of diagnoses made by AADD. Our patient population was two groups of children with and without cardiac disease(563 patients and 50 normal). SPSS version 16 was used to calculate sensitivity, specificity and efficiency and descriptive analysis. Using cardiac sound recording in four conventional cardiac areas of auscultation (including aortic, pulmonary, tricuspid and mitral), AADD proved to have a ≥90 % sensitivity, specificity and efficiency for making the correct diagnosis in children with heart disease and 100% diagnostic accuracy in children with normal hearts either with or without innocent murmurs. Considering the high sensitivity, specificity and efficiency of AADD for making the correct diagnosis, application of this software is recommended for family physicians to enhance proper and timely patients’ referral to pediatric cardiologists in order to provide better diagnostic facilities for pediatric patients who live in deprived and underserved rural areas with lack access to pediatric cardiologists.