Auscultation: Act of listening for sounds within the body.Respiratory Sounds: Noises, normal and abnormal, heard on auscultation over any part of the RESPIRATORY TRACT.Stethoscopes: Instruments intended to detect and study sound produced by the heart, lungs, or other parts of the body. (from UMDNS, 1999)Diagnosis, Computer-Assisted: Application of computer programs designed to assist the physician in solving a diagnostic problem.Sound: A type of non-ionizing radiation in which energy is transmitted through solid, liquid, or gas as compression waves. Sound (acoustic or sonic) radiation with frequencies above the audible range is classified as ultrasonic. Sound radiation below the audible range is classified as infrasonic.Sound Localization: Ability to determine the specific location of a sound source.Heart Sounds: The sounds heard over the cardiac region produced by the functioning of the heart. There are four distinct sounds: the first occurs at the beginning of SYSTOLE and is heard as a "lubb" sound; the second is produced by the closing of the AORTIC VALVE and PULMONARY VALVE and is heard as a "dupp" sound; the third is produced by vibrations of the ventricular walls when suddenly distended by the rush of blood from the HEART ATRIA; and the fourth is produced by atrial contraction and ventricular filling.Sound Spectrography: The graphic registration of the frequency and intensity of sounds, such as speech, infant crying, and animal vocalizations.Acoustic Stimulation: Use of sound to elicit a response in the nervous system.Auditory Perception: The process whereby auditory stimuli are selected, organized, and interpreted by the organism.Acoustics: The branch of physics that deals with sound and sound waves. In medicine it is often applied in procedures in speech and hearing studies. With regard to the environment, it refers to the characteristics of a room, auditorium, theatre, building, etc. that determines the audibility or fidelity of sounds in it. (From Random House Unabridged Dictionary, 2d ed)Auditory Pathways: NEURAL PATHWAYS and connections within the CENTRAL NERVOUS SYSTEM, beginning at the hair cells of the ORGAN OF CORTI, continuing along the eighth cranial nerve, and terminating at the AUDITORY CORTEX.Hearing: The ability or act of sensing and transducing ACOUSTIC STIMULATION to the CENTRAL NERVOUS SYSTEM. It is also called audition.Auditory Cortex: The region of the cerebral cortex that receives the auditory radiation from the MEDIAL GENICULATE BODY.Noise: Any sound which is unwanted or interferes with HEARING other sounds.Evoked Potentials, Auditory: The electric response evoked in the CEREBRAL CORTEX by ACOUSTIC STIMULATION or stimulation of the AUDITORY PATHWAYS.Psychoacoustics: The science pertaining to the interrelationship of psychologic phenomena and the individual's response to the physical properties of sound.Auditory Threshold: The audibility limit of discriminating sound intensity and pitch.Heart Auscultation: Act of listening for sounds within the heart.
Auscultation: Auscultation (based on the Latin verb auscultare "to listen") is listening to the internal sounds of the body, usually using a stethoscope. Auscultation is performed for the purposes of examining the circulatory and respiratory systems (heart and breath sounds), as well as the gastrointestinal system (bowel sounds).StethoscopeComputer-aided diagnosis: In radiology, computer-aided detection (CADe), also called computer-aided diagnosis (CADx), are procedures in medicine that assist doctors in the interpretation of medical images. Imaging techniques in X-ray, MRI, and Ultrasound diagnostics yield a great deal of information, which the radiologist has to analyze and evaluate comprehensively in a short time.Sound changeMasakazu Konishi: Gruber Prize in Neuroscience Yamashina AwardFourth heart soundAuditory scene analysis: In psychophysics, auditory scene analysis (ASA) is a proposed model for the basis of auditory perception. This is understood as the process by which the human auditory system organizes sound into perceptually meaningful elements.Acoustics Research InstituteEquivalent rectangular bandwidth: The equivalent rectangular bandwidth or ERB is a measure used in psychoacoustics, which gives an approximation to the bandwidths of the filters in human hearing, using the unrealistic but convenient simplification of modeling the filters as rectangular band-pass filters.List of noise topics: This is a list of noise topics.Auditory event: Auditory events describe the subjective perception, when listening to a certain sound situation. This term was introduced by Jens Blauert (Ruhr-University Bochum) in 1966, in order to distinguish clearly between the physical sound field and the auditory perception of the sound.Psychoacoustics: Psychoacoustics is the scientific study of sound perception. More specifically, it is the branch of science studying the psychological and physiological responses associated with sound (including speech and music).Cardiovascular examination: The Cardiovascular examination is a portion of the physical examination that involves evaluation of the cardiovascular system.
(1/1139) Time course of respiratory decompensation in chronic obstructive pulmonary disease: a prospective, double-blind study of peak flow changes prior to emergency department visits.
The aim of this study was to look at changes in peak expiratory flow rates (PEFR) prior to emergency department visits for decompensated chronic obstructive pulmonary disease (COPD). It was designed as a prospective, double-blind study at the Albuquerque Veterans Affairs Medical Center. Twelve patients with an irreversible component of airflow obstruction on pulmonary function tests were assessed. At entry, all subjects were instructed in the use of a mini-Wright peak flow meter with electronic data storage. They then entered a 6-month monitoring phase in which they recorded PEFR twice daily, before and after bronchodilators. The meter displays were disabled so that the patients and their physicians were blinded to all values. Medical care was provided in the customary manner. Patients were considered to have respiratory decompensation if they required treatment for airflow obstruction in the Emergency Department (ED) and no other causes of dyspnea could be identified. Simple linear regression was used to model changes in PEFR over time. The 12 subjects had 22 episodes of respiratory decompensation during 1741 patient-days of observation. Two episodes could not be analysed because of missing values. Ten episodes in seven subjects were characterized by a significant linear decline in at least one peak flow parameter prior to presentation. The mean rates of change for the four daily parameters varied from 0.22% to 0.27% predicted per day (or 1.19 to 1.44 1 min-1 day-1). The average decrement in these parameters ranged from 30.0 to 33.8 1 min-1 (or 18.6%-25.9% of their baseline values). No temporal trends were found for the 10 episodes occurring in the other five subjects. We concluded that respiratory decompensation is characterized by a gradual decline in PEFR in about half of cases. Future studies should be done to elucidate the mechanisms of respiratory distress in the other cases. (+info)
(2/1139) Randomised controlled trial of budesonide for the prevention of post-bronchiolitis wheezing.
BACKGROUND: Previous studies suggest that recurrent episodes of coughing and wheezing occur in up to 75% of infants after acute viral bronchiolitis. AIM: To assess the efficacy of budesonide given by means of a metered dose inhaler, spacer, and face mask in reducing the incidence of coughing and wheezing episodes up to 12 months after acute viral bronchiolitis. METHODS: Children under the age of 12 months admitted to hospital with acute viral bronchiolitis were randomised to receive either budesonide or placebo (200 microg or one puff twice daily) for the next eight weeks. Parents kept a diary card record of all episodes of coughing and wheezing over the next 12 months. RESULTS: Full follow up data were collected for 49 infants. There were no significant differences between the two study groups for the number of infants with symptom episodes up to six months after hospital discharge. At 12 months, 21 infants in the budesonide group had symptom episodes compared with 12 of 24 in the placebo group. The median number of symptom episodes was 2 (range, 0-13) in those who received budesonide and 1 (range, 0-11) in those who received placebo. Because there is no pharmacological explanation for these results, they are likely to be caused by a type 1 error, possibly exacerbated by there being more boys in the treatment group. CONCLUSION: Routine administration of budesonide by means of a metered dose inhaler, spacer, and face mask system immediately after acute viral bronchiolitis cannot be recommended. (+info)
(3/1139) Persistent cough: is it asthma?
The aim of this study was to determine if children in the community with persistent cough can be considered to have asthma. A validated questionnaire was given to the parents of 1245 randomly selected children aged 6-12 years. Atopy was measured with skin prick tests. Children with persistent cough had less morbidity and less atopy compared with children with wheeze. Although the syndrome commonly referred to as "cough variant asthma" could not be shown in this study, a significant number of children with persistent cough had been diagnosed as having asthma and were treated with asthma medications including inhaled corticosteroids. Studies are urgently needed to determine the appropriate treatment for children with persistent cough. (+info)
(4/1139) Repeatability of lung function tests during methacholine challenge in wheezy infants.
BACKGROUND: The repeatability of lung function tests and methacholine inhalation tests was evaluated in recurrently wheezy infants over a one month period using the rapid thoracic compression technique. METHODS: Eighty-one wheezy, symptom free infants had pairs of methacholine challenge tests performed one month apart. Maximal flow at functional residual capacity (VmaxFRC) and transcutaneous oxygen tension (Ptco2) were measured at baseline and after methacholine inhalation. Provocative doses of methacholine causing a 15% fall in Ptco2 (PD15 Ptco2) or a 30% fall in VmaxFRC (PD30 VmaxFRC) were determined. RESULTS: Large changes in VmaxFRC were measured from T1 to T2 with a mean difference between measurements (T2-T1) of 7 (113) ml/s and a 95% range for a single determination for VmaxFRC of 160 ml/s. The mean (SD) difference between pairs of PD30 VmaxFRC measurements was 0.33 (1.89) doubling doses with a 95% range for a single determination of 2.7 doubling doses. Repeatability of PD15Ptco2 was similar. A change of 3.7 doubling doses of methacholine measured on successive occasions represents a significant change. CONCLUSIONS: Baseline VmaxFRC values are highly variable in wheezy, symptom free infants. Using either VmaxFRC or Ptco2 as the outcome measure for methacholine challenges provided similar repeatability. A change of more than 3.7 doubling doses of methacholine is required for clinical significance. (+info)
(5/1139) Forced expiratory wheezes in a patient with dynamic expiratory narrowing of central airways and an oscillating pattern of the flow-volume curve.
Forced expiratory wheezes (FEW) are common and the pathogenesis of this phenomenon might involve fluttering of the airways, but this theory has not been confirmed in patients. We report a case of a patient with FEW and a normal FEV1 that showed a bronchoscopically confirmed collapse of the trachea and main stem bronchi during forced expiration. Superimposed to the flow-volume curve was an oscillating pattern with a frequency that corresponded well with the wheeze generated during forced expiration. The oscillating pattern in the flow-volume curve and the collapse of the major airways supports the theory of wheezes generated by fluttering airways during forced expiration. Although FEW may be found also in healthy subjects, flow limitation is essential for the generation of FEW. The inclusion of a forced expiratory maneuver in the clinical examination might therefore be helpful in guiding the diagnosis towards airways obstruction. (+info)
(6/1139) Age-dependent altered proportions in subpopulations of tonsillar lymphocytes.
Age-related changes in functional subsets of lymphocytes may influence the potential to build up immune responses. In particular, the capacity of tonsillar lymphocytes to counter infections may be altered during ageing. In order to address this question we investigated the proportional distribution of several subsets of tonsillar T and B cells with regard to ageing. Tonsils were derived from 119 patients between 2 and 65 years of age. Lymphocyte subsets were monitored by three-colour fluorescence of relevant CD markers in flow cytometry. As a general tendency the percentage of CD3+ T cells steadily increased whereas that of CD19+ B cells decreased at the same time. No significant differences were observed between lymphocytes of patients with and without inflammatory history of the tonsils. The percentage of CD8+ T cells declined whereas that of CD4+ T cells increased during the same time span. CD45RA+ T cells increased during the first two decades of life and gradually decreased thereafter. In contrast, CD45RO+ T cells showed an opposite trend. No differences were seen in the population of CD3-/CD56+ natural killer (NK) cells. The mature B cell marker CD40 showed no significant changes during ageing. However, CD38+ B cells, representing B cells of late maturation stages, dramatically declined up to the age of 65. In a similar manner the CD5+ subpopulation of B cells decreased during ageing. Substantial changes in major tonsillar T and B cell populations as shown in this study may have an impact on the ageing process of the immune system. (+info)
(7/1139) Birth weight, body mass index and asthma in young adults.
BACKGROUND: Impaired fetal growth may be a risk factor for asthma although evidence in children is conflicting and there are few data in adults. Little is known about risk factors which may influence asthma in late childhood or early adult life. Whilst there are clues that fatness may be important, this has been little studied in young adults. The relations between birth weight and childhood and adult anthropometry and asthma, wheeze, hayfever, and eczema were investigated in a nationally representative sample of young British adults. METHODS: A total of 8960 individuals from the 1970 British Cohort Study (BCS70) were studied. They had recently responded to a questionnaire at 26 years of age in which they were asked whether they had suffered from asthma, wheeze, hayfever, and eczema in the previous 12 months. Adult body mass index (BMI) was calculated from reported height and weight. RESULTS: The prevalence of asthma at 26 years fell with increasing birth weight. After controlling for potential confounding factors, the odds ratio comparing the lowest birth weight group (<2 kg) with the modal group (3-3.5 kg) was 1.99 (95% CI 0.96 to 4.12). The prevalence of asthma increased with increasing adult BMI. After controlling for birth weight and other confounders, the odds ratio comparing highest with lowest quintile was 1.72 (95% CI 1.29 to 2.29). The association between fatness and asthma was stronger in women; odds ratios comparing overweight women (BMI 25-29.99) and obese women (BMI >/=30) with those of normal weight (BMI <25) were 1.51 (95% CI 1.11 to 2.06) and 1.84 (95% CI 1. 19 to 2.84), respectively. The BMI at 10 years was not related to adult asthma. Similar associations with birth weight and adult BMI were present for wheeze but not for hayfever or eczema. CONCLUSIONS: Impaired fetal growth and adult fatness are risk factors for adult asthma. (+info)
(8/1139) Pertussis vaccination and wheezing illnesses in young children: prospective cohort study. The Longitudinal Study of Pregnancy and Childhood Team.
OBJECTIVES: To examine the relation between pertussis vaccination and the prevalence of wheezing illnesses in young children. DESIGN: Prospective cohort study. SETTING: Three former health districts comprising Avon Health Authority. SUBJECTS: 9444 of 14 138 children enrolled in the Avon longitudinal study of pregnancy and childhood and for whom data on wheezing symptoms, vaccination status, and 15 environmental and biological variables were available. MAIN OUTCOME MEASURES: Episodes of wheezing from birth to 6 months, 7-18 months, 19-30 months, and 31-42 months. These time periods were used to derive five categories of wheezing illness: early wheezing (not after 18 months); late onset wheezing (after 18 months); persistent wheezing (at every time period); recurrent wheezing (any combination of two or more episodes for each period); and intermittent wheezing (any combination of single episodes of reported wheezing). These categories were stratified according to parental self reported asthma or allergy. RESULTS: Unadjusted comparisons of the defined wheezing illnesses in vaccinated and non-vaccinated children showed no significant association between pertussis vaccination and any of the wheezing outcomes regardless of stratification for parental asthma or allergy. Wheeze was more common in non-vaccinated children at 18 months, and there was a tendency for late onset wheezing to be associated with non-vaccination in children whose parents did not have asthma, but this was not significant. After adjustment for environmental and biological variables, logistic regression analyses showed no significant increased relative risk for any of the wheezing outcomes in vaccinated children: early wheezing (0.99, 95% confidence interval 0.80 to 1.23), late onset wheezing (0.85, 0.69 to 1.05), persistent wheezing (0.91, 0.47 to 1.79), recurrent wheezing (0.96, 0.72 to 1.26), and intermittent wheezing (1.06, 0.81 to 1.37). CONCLUSIONS: No evidence was found that pertussis vaccination increases the risk of wheezing illnesses in young children. Further follow up of this population with objective measurement of allergy and bronchial responsiveness is planned to confirm these observations. (+info)