Do attending physicians really percuss?
Article Abstract:
An evaluation is presented of the role of percussion in modern medicine, a diagnostic procedure that uses the fingertips to tap the body lightly to define the borders of underlying structures and to detect fluid in bodily cavities. For the most part, medical students quickly learn that high technology tests are preferable to percussion, and forget the basic techniques they have been taught early in their training. An article in the September 30, 1991 issue of The American Journal of Medicine reports on the value of cardiac percussion as determined in a study that used sophisticated research methods. The role of percussion of the liver and heart is to define their borders, not to diagnose disease in the organs (unlike for the lungs, where listening can reveal much about health). The latter type of percussion is called 'sonorous', and the former, 'definitive'. Methods of percussion are discussed. Several new approaches have recently been developed, which may have effects on clinical practice. Attractions of this low technology method of examination include the inherent rewards to patient and physician in the laying on of hands, and the opportunity for the physician to control cost by waiving a fee if necessary, something institutions or imaging centers cannot do. Criticisms can be levied against the Journal article, however, such as the impossibility of detecting certain cardiac impulses in many patients, and the fact that percussion can give similar results in thin and overweight patients. Clearly, additional research on the subject is needed. Meanwhile, internists should use their clinical skills and learn better percussion techniques. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1991
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A study of the rate of postexposure human immunodeficiency virus testing in a hospital requiring written informed consent
Article Abstract:
Many authorities have suggested that HIV testing should only be performed with the consent of the patient. A hospital implemented a policy requiring individuals' consents before testing them for HIV antibodies, when an employee had been accidentally exposed to the individuals' blood or body fluids. The rate of testing in such incidents was then studied. Two hundred and four employees were exposed to patients' blood or body fluids, and in ninety percent of these cases, the patient from whom the material came was identified. HIV tests were performed on 68 percent of these patients. One patient refused to be tested, and consent could not be obtained in 32 percent of the cases due to logistical reasons. The policy resulted in an unacceptably low rate of testing; a more enforceable approach needs to be developed.
Publication Name: Journal of Occupational Medicine
Subject: Health care industry
ISSN: 0096-1736
Year: 1989
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Special obtaining permission for an autopsy: its importance for patients and physicians
Article Abstract:
This paper reviews the benefits of the increasing number of autopsies being performed. The paper deals with specific procedures for obtaining consent to autopsy from the next of kin. The paper presents advice to physicians for dealing with families that will lead to a general increase in the number of autopsy permissions obtained, and for an improvement in overall physician performance and satisfaction.
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1989
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- Abstracts: Delayed diagnosis of tuberculosis in patients with human immunodeficiency virus infection. Dysphagia and an abdominal mass in a 43-year-old man with acquired immunodeficiency syndrome
- Abstracts: Delayed diagnosis of tuberculosis in patients with human immunodeficiency virus infection. part 2 Diphenylhydantoin-induced hypogammaglobulinemia in a patient infected with human immunodeficiency virus
- Abstracts: Industrial employee drug screening: a blind study of laboratory performance using commercially prepared controls
- Abstracts: Long-Term Care Insurance: The Edge of an Emerging Market. The Capital Requirements for Long-Term Care Facilities
- Abstracts: Physician Incentive Compensation in Group Practice: A Review with Suggestions for Improvement. Application of continuous quality improvement techniques to the treatment of patients with hypertension