X-ray examination of small intestine--conventional enteroclysis and CT enterography

We gave an outline while showing the image about conventional enteroclysis and CT enterography as X-ray examination of small intestine. Recently a double balloon enteroscopy and wireless capsule endoscopy have been used as new procedure for small intestinal examination. The former is high invasive examination for a patient and has a risk of perforation for the patients with intestinal adhesion and consequently it is unsuitable as screening examination. And for the latter, the stoppage to stenosis locus of a capsule becomes a problem for a patient having intestinal stenosis. Therefore, a conventional enteroclysis is still necessary at present. On the other hand, CT enterography which is new small intestinal examination procedure is attracting attention as the examination of low invasiveness except the exposure to radiation and equally taking very short time during examination. CT enterography will be it with more and more useful examination for the small intestine in a diagnosis of intestinal neoplasia, ileus and inflammatory bowel disease such as Crohn's disease in future.     

Examining adult male genitalia: providing a guide for the nurse

This article provides the nurse with an overview and guidance concerning examination of the adult male genitalia. Issues such as ensuring privacy, developing a relationship and explaining the procedure are discussed. Advice is provided that will allow the nurse to perform the examination using sight, palpation and transillumination, activities that are central to the examination. An overview of the structure and function of male genitalia is provided. Examination of the male genitalia is an intimate activity and in this article emphasis is placed on the issues of informed consent and the importance of ensuring that each patient has a chaperone present during the examination. Detailed discussion is provided to enable the nurse to use a step-by-step approach to ensure a thorough and detailed examination is performed. A checklist and review of the examination process is included.     

秦皇岛健康体检人群胸部X线检查7972例临床分析

目的研究秦皇岛健康体检人群胸部X检查的表现及临床应用价值,指导该项目在健康体检中的合理选择。方法对本体检中心2010-01—2011-12体检资料进行回顾性分析,统计胸部X线检查方式及阳性率。结果胸部X线检查仍以X线透视为主（81.92%）;阳性率极低,为2.07%,且与性别、年龄有关。结论健康体检胸部X线检查照射剂量大,阳性率低,应根据病史、职业、性别、年龄等进行个性化选择,不应作为体检普查项目。     

Evolution and quality assurance of the primary examination of the Australasian College for Emergency Medicine

The primary examination of the Australasian College for Emergency Medicine is an important part of the College's training and examination structure. It is seen by many doctors undertaking a career in emergency medicine as a considerable hurdle in their training program. This paper describes the evolution of the primary examination and explains the measures that have been instituted to ensure that the examination is consistent, relevant, fair and objective.     

Enteroclysis: The small bowel enema

Enteroclysis, the infusion of contrast medium directly into the small bowel, is a precise, rapid method for thorough small bowel examination. This technique demonstrates far more pathology than any other method when it is properly executed. However, the examination is sure to fail with poor techniques, thereby discrediting a superb method. Experience has shown that failures are usually due to inadequate technique or poor judgment or both during the examination. This article covers the proper and improper techniques of the examination and gives examples of each. The most common problems that arise during the examination are discussed in the order in which they usually develop.     

健康查体人员年龄与查体费用、查体时间相关因素调查

目的 通过对健康查体人员的问卷调查,探讨现代人查体年龄与查体费用和查体间隔时间的关系并做出评价。方法 自行设计调查量表,自2003年3月至2003年6月对疗养院门诊查体人员进行调查,对收回的235份有效问卷进行统计分析。结果 显示健康查体人员年龄与查体时间密切相关,50岁以上两组人员中,1年次查体率分别达75％和88．89％,无3年次查体;而查体费用与年龄关系中,60岁以下各年龄组75％以上均为公费缴纳,大于60岁年龄组则个人支付超过公费缴纳。结论 查体的间隔时间与年龄相比除小于19岁组外差别不大;但查体费用有较大反差。提示应掌握正确的健康定义,加大对预防保健的投入。     

An analysis of Michigan EMT licensure examination results as a predictor of paramedic licensure examination success

INTRODUCTION: Predicting paramedic candidate performance on the written licensure examination is of considerable importance to educators, students, employers, and state regulators. There has been little investigation of the available statistical data regarding examinee pass rate and examination score. No studies have measured an examinee's sequential success pattern on the basic emergency medical technician (EMT) or paramedic examinations. There has been no analysis of the relationship between the number of examinations required for successful paramedic licensure and examination score. OBJECTIVE: The purpose of this study was to determine the frequency with which paramedic licensure examinees successfully pass the State of Michigan written examination on the first or subsequent attempts; to determine the frequency with which the paramedic examinees pass the prerequisite basic EMT licensure examination; to determine whether the frequency of paramedic examination attempts is related to examination score; and to determine whether there is a relationship between successfully passing the basic EMT examination and successfully passing the paramedic examination. METHODS: A retrospective study of Michigan paramedic licensure examination results for 1994 was done on the basis of a review of reports prepared for Michigan Department of Public Health Emergency Medical Services (MDPH-EMS) by Professional Examination Services. Analysis of paramedic examination score and the number of examination attempts is correlated to EMT score and number of attempts required to pass. Success in the first or subsequent paramedic examinations is correlated to paramedic score, and success in passing the first or subsequent EMT examination is then related to success in passing the paramedic examination. RESULTS: Paramedic examinees (n = 869) generated a 72.1% pass rate in 1994 (mean score = 82.2%). The minimum passing score is 80%. The average score for examinees who passed (n = 627) was 86.2% (95% confidence interval [CI] = 85.8-86.6%); those who failed (n = 242) averaged 71.9% (95% CI = 71.1-72.6%). Paramedic examinees successful on the first attempt (n = 500) had higher average scores (mean = 87.1%; 95% CI = 86.7-87.5%) than did those who required multiple attempts (mean = 82.8%; 95% CI = 82.3-83.3%; n = 127). A total of 702 (90.5%) paramedic examinees passed the EMT examination on the first attempt. Examinees who passed the EMT examination the first time averaged fewer attempts on the paramedic examination (mean 1.5; 95% CI = 1.4-1.6) than did those who required multiple EMT examinations (mean 2.3; 95% CI = 2.0-2.6). Paramedic examinees passing the EMT examination in one attempt had higher average paramedic scores (82.6%; 95% CI = 82.1-83.2%) than those needing multiple EMT attempts (75.5%; 95% CI = 73.4-77.5%). CONCLUSION: Paramedic examinees who pass their EMT licensure examination on the first attempt have a significantly better chance of passing the paramedic licensure examination. Paramedic licensure examinees who pass the paramedic examination on the first attempt score significantly higher than do examinees who require additional attempts. Paramedic programs should incorporate EMT examination performance into their student selection criteria. Further study of variables predictive of success is needed.     

Predictive value of a senior comprehensive examination as to performance on a national certification examination.

OBJECTIVE: To determine what value a senior departmental comprehensive examination holds in predicting the future success of a student on the MT(ASCP) certification examination. DESIGN: Part 1: To evaluate the efficacy of the comprehensive examination, scores were obtained in the examination categories of hematology, clinical chemistry, immunohematology, and microbiology for all dinical laboratory science students who have graduated from the University of Mississippi Medical Center since 1993. The data were analyzed to determine if a correlation exists between student performance on the senior comprehensive, and their future performance on the MT(ASCP) national certification examination. Part 2: To determine the extent to which a senior comprehensive examination was required for graduation at other university-based clinical laboratory science programs, a simple survey was e-mailed to members of the clinical laboratory science educators forum. SETTING: 2+2 university-based dinical laboratory science program PARTICIPANTS: Part 1: Previous graduates of the Clinical Laboratory Science Program at the University of Mississippi Medical Center since 1993. Part 2: Program directors who are members of the Clinical Laboratory Sciences Educator's Forum. RESULTS: Part 1: Results indicated a distinct division between participants who scored higher than 74.36% (Group A) on the senior comprehensive examination, and those scoring below 74.36% (Group B). In Group A, 100% of participants passed the MT(ASCP) national certification examination on the first attempt. Results were mixed for Group B. Part 2: The survey indicated that of the 40 respondents, most were similar to the University of Mississippi Medical Center Clinical Laboratory Science Program in that they require a comprehensive to be taken, that the grade received is part of another course grade, and that the examination is prepared using questions submitted by the faculty. CONCLUSIONS: Part 1: The senior departmental comprehensive examination is of value in predicting the future success of a student on the MT(ASCP) national certification examination. Part 2: Unlike the University of Mississippi Medical Center, 16 of the 40 respondents stated that passage of the comprehensive examination was a requirement for graduation. In those programs, the comprehensive was a major part of a course grade.     

Examination of the newborn: The innocent heart murmur

The role of the health professional is constantly changing and evolving, and as areas of practice expand, this requires advanced skills. The midwife in extending her role to become professionally competent in the examination and assessment of the newborn facilitates the provision of holistic care for the woman, infant and family.This is a case study report of an infant diagnosed with an innocent heart murmur on the first neonatal examination. It explores the transitional process of a midwife extending her role in performing the neonatal examination and critically evaluating the neuro-behavioural physiological assessment of the infant and covers areas of debate including which practitioner should be performing the examination and the timing of the examination.     

The complete health checkup: fad, fiction, or fact.

The ritual of the annual physical examination is scrutinized with respect to its clinical value. The periodic physical examination is not usually a health examination, because it does not include all components that affect a person's total health. The annual physical examination is usually not of importance to the physician unless disease is discovered. Seldom is the examination used as an opportunity to reinforce behaviors which have kept the patient healthy. It has been suggested that physician extenders be used to deliver primary care services, including comprehensive health examinations, with physicians used as backup. Laymen should not have to seek out specialists to give them examinations for each system of the body. Comprehensive health care should be available and accessible to all segments of the public with an emphasis on greater self-responsibility for maintaining one's health and enhancing one's wellness.     

Teaching and evaluation of physical examination skills on the surgical clerkship

It is presumed that graduating medical students possess adequate physical examination skills, although they are rarely evaluated during the clinical years. In this study we assessed the physical examination skills of third‐year medical students at the beginning and end of a surgical clerkship and investigated the effect of clerkship experiences and formal feedback on maturation of these skills. Sixty‐seven third‐year students completed a course on physical examination during their second year of medical school and achieved a 90% performance level on a physical examination performed on a patient instructor. This group subsequently performed a focused physical examination (chest, abdomen, groin [hernia], and external genitalia) during Week 1 and Week 6 of a 6‐week third‐year surgical clerkship. The physical examination was observed and evaluated using a 38‐item checklist; feedback was provided immediately after the first examination. Pretest performance was significantly poorer than that achieved in the second‐year course. Statistically significant improvement was noted from pretest to posttest for all areas except the external genitalia examination. Students in later rotations in the academic year did not perform significantly better than students in early rotations. We concluded that deterioration of learned physical examination skills occurs from the preclinical to the clinical years and that this deficiency is not corrected by clerkship experiences. Evaluation and feedback during the clerkship resulted in improvements in skills back to the levels demonstrated during the second year.     

探讨医学网络教育考试系统的漏洞

目的：基于网络考试的实际经验,分析现有医学继续教育网站在考试系统方面的技术漏洞。方法：利用经验预测可能存在的系统漏洞,通过实验进行验证,并分析系统漏洞产生的原因。结果：现有的医学网络考试系统很好的满足了广大医务人员的需求,但是由于考试系统和网站管理方面的漏洞,可能使继续教育学习失去意义。结论：考试系统漏洞的解决lwi办法有待进一步探讨。     

健康体检路径在体检中心优质护理服务中的应用

目的:探讨健康体检路径在体检中心优质护理服务中的应用效果.方法:选取8 679例在体检中心进行体检者,随机分为观察组4 340例和对照组4 339例,分别应用健康体检路径模式、原体检流程进行体检,调查、比较两组体检效果及其对护理人员的评价.结果:两组受检时间、体检效率、体检可信度、受检者满意度比较差异均有统计学意义(P＜0.05,P＜0.01),观察组对护理人员服务礼仪、沟通能力、主动服务、健康宣教的评价均高于对照组(P＜0.05).结论:健康体检路径是提高体检服务质量、缩短体检时间,增加体检效率,提高护理人员素质、实施优质护理服务的有效工作模式,是一种积极的管理模式,值得推广.     

泌尿系结石的X线平片准确性分析

目的评价X线对泌尿系结石的诊断价值。方法对328例泌尿系结石患者的B超、X线检查结果进行对比分析。结果B超、X线对泌尿系结石均有较高的诊断率，分别为78．7％和89．3％。结论X线诊断泌尿系结石的准确率更高，应为泌尿系结石的诊断的首选方法，同时辅以B超提高准确率。     

The role of the physical examination in clinical assessment: a useful skill for professional nursing

Clinical Assessment by professional nurses relies upon appropriate gathering and interpretation of relevant subjective and objective biopsychosocial data. The physical examination provides primary objective data through the use of four techniques: inspection, percussion, palpation, and auscultation. In many countries the physical examination of patients is regarded as a standard source of clinical information for nurses. In daily nursing practice problem-focused physical examination is the rule, though complete physical examinations are commonly used in advanced nursing practice at the Master level. In this article the role of physical examination in professional nursing assessment is described, physical examination techniques are introduced and illustrated via case examples. The importance of including assessment competencies in academic nursing education is emphasized.     

Physical examination: a revered skill under scrutiny

Clinicians in the 1980s rely on the physical examination to a lesser degree than their predecessors in making diagnostic and therapeutic decisions. The major criticisms are that the physical examination lacks sensitivity for many common diseases and has not been subjected to the same scientific scrutiny afforded laboratory testing. On the positive side, the physical examination is a series of diagnostic maneuvers that permit physicians to test hypotheses generated during history taking, to determine disease severity, and to lessen clinical uncertainty. Furthermore, the physical examination fosters the development of personalized medical care and a bond of mutual trust between patient and doctor. The challenge for tomorrow is to determine the operating characteristics of physical examination techniques and the clinical utility of physical findings. For preclinical students, emphasis should be directed at basic examination principles and sequencing. Many model programs have used patient instructors and other innovative techniques. Clinical students and postgraduate trainees need emphasis on interpretation of physical findings and their integration into the clinical context. There is no substitute for bedside teaching at this level.     

碘水造影检查在食管异物穿孔诊断中的价值

目的 探讨碘水造影检查在食管异物穿孔中的诊断价值.方法 用碘帕醇注射液加等量0.9％生理盐水稀释后,以口服方式给药,行胸部立位X线透视或摄片检查,了解食管是否有穿孔.结果 碘水造影检查能很好显示13例食管异物穿孔的位置.结论 碘水造影检查是一项安全的检查,可以作为诊断食管异物穿孔的一种有效方法.     

Impact of an In-Person Versus Web-Based Practice Standardized Patient Examination on Student Performance on a Subsequent High-Stakes Standardized Patient Examination

Background: Optimal methods of preparing students for high-stakes standardized patient (SP) examinations are unknown. Purposes: The purpose is to compare the impact of two formats of a formative SP examination (Web-based vs. in-person) on scores on a subsequent high-stakes SP examination and to compare students' satisfaction with each formative examination format. Methods: Clustered randomized trial comparing a Web-based module versus in-person formative SP examination. We compared scores on a subsequent high-stakes SP examination and satisfaction. Results: Scores on the subsequent high-stakes SP examination did not differ between the two formative formats but were higher after the formative assessment than without (p < .001). Satisfaction was higher with the in-person than Web-based formative assessment format (4.00 vs. 3.62 on a 5-point scale, p = .01). Conclusions: Two formats of a formative SP examination led to equivalent improvement in scores on a subsequent high-stakes examination. Students preferred an in-person formative examination to online but were satisfied with both.