Search

The current preventive trends in clinical examination draw attention to the role of the external factors and stressful circumstances in psychodiagnostic research. Social frustration is an incapacity to fulfill relevant social needs because of a current situation. This term makes it possible to qualify criteria for the potential stress related to social functioning among family members, colleagues, and peers. The authors rationalized and tested a formalized questionnaire of Social Frustration Level developed at Bekhterev National Medical Research Centre for Psychiatry and Neurology in 2004 for patients with social adjustment disorders. The experiment justified the criterion validity of the Social Frustration Level Questionnaire. The article describes the structure of social frustration regarding the key spheres of activity attributed to internal and external frustration. The pilot study involved 45 patients with adjustment disorders, who showed significant frustration related to health problems and socio-economic status accompanied with relative satisfaction with interpersonal relations, i.e., family, friends, colleagues, and strangers. The research relied on the method of clinical psychological interview, as well as the Questionnaire of Social Frustration Level and the Integrative Anxiety Test. Personal anxiety and actual anxiety experiences proved to correlate with social frustration. The internal social frustration prevailed over the external one. The Questionnaire of Social Frustration Level proved to be an efficient practical tool to be used in systematic medical psychodiagnostics research, programs of disorder prevention, and psychotherapy.

Undernutrition is a frequent problem in medicine. In practice, it concerns all practitioners, whether they work in the city, in hospitals, or in medico-social structures. In view of its deleterious physiopathological consequences for each individual, it deserves to be diagnosed and screened, particularly in certain high-risk situations (notably in the case of a lack of intake, increased needs and losses) and in principle in the elderly. In this context, the tools available to the practitioner are numerous, including: data from the clinical examination, anthropometric data (weight, BMI, skin folds), biological data (mainly albumin, transthyretin, BPR), and composite indices and nutritional scores (including the MNA, NRI, SGA, NRS- 2002 and MUST) [ABSTRACT FROM AUTHOR]

Introduction: we conducted the first epidemiological study of patients with breast cancers living in Fianarantsoa. The purpose of this study was to describe the epidemiology and clinical features of these patients in the Department of Oncology Fianarantsoa. Methods: we conducted a retrospective and descriptive study in the Department of Oncology at the University Hospital Center of Tambohobe over a period of 8 years (2011-2018). All patients with breast cancer diagnosed based on cytological and/or histological examination were included. The parameters studied were: age, occupation, a family history of breast cancer, menarche, menopause, parity, use of oral contraceptives, smoking, circumstances leading to detection, breast symptoms, signs of locoregional and distant spread, tumour site and stage of the disease. Results: the study included 62 patients with an average age of 52.83 ± 10.47 years. Housewives accounted for 39% (n = 24) of cases. No patient had an early menarche. Late menopause had occurred in 6.45% (n = 4) of patients and a family history of breast cancer was found in 8.06% (n = 5) of patients. Chewing tobacco was used by 17.74% (n = 11) of patients. Patients reporting breast symptoms accounted for 95.2% (n = 59). Breast cancers had affected the upper outer quadrant in 53.23% (n = 33) of cases. Stage III breast cancer was diagnosed in 55% (n = 34) of cases and stage IV in 32% (n = 20) of cases. Conclusion: in patients diagnosed with cancer at an advanced stage, risk factors for breast cancer were little observed. [ABSTRACT FROM AUTHOR]

The role of occlusal interference as an etiologic factor of TMD dysfunction has been discussed for a long time. Now, it has been well established that occlusal interferences play a very little part in this dysfunction. Therefore, occlusal interferences are considered as an adaptation and not the cause for the disturbance of manducatory functions Furthermore, occlusal interferences exacerbate difficulties in performing incision and phonation. Decision making in occlusal adjusment is very controversial and indication are now limited to oral rehabilitation and restorative dentistry. [ABSTRACT FROM AUTHOR]

Objectives: Breast cancer is the most common female cancer in the world. In France, over 60,000 new cases are currently diagnosed, and 12,000 deaths are attributed to it annually. Numerous studies have shown that the risk of metastatic disease increases with tumor volume. In this context, it is useful to assess whether the regular practice of breast self-examination (BSE) has an impact on the number of cancers diagnosed, their stage, the treatments used and mortality., Design: the CNGOF's Commission de Sénologie (CS), composed by 17 experts and 3 invited members, drew up these recommendations. No funding was provided for the development of these recommendations. The CS respected and followed the GRADE (Grading of Recommendations Assessment, Development and Evaluation) method to assess the quality of the evidence on which the recommendations were based., Methods: The CS studied 16 questions concerning BSE, individualizing four groups of women (general population, women aged over 75, high-risk women, and women previously treated for breast cancer). For each situation, it was determined whether the practice of BSE compared with abstention from this examination led to the detection of more breast cancers and/or recurrences and/or reduced treatment and/or increased survival., Results: BSE should not be recommended for women in the general population, who otherwise benefit from a clinical breast examination (by the attending physician or gynecologist) from the age of 25, and from organized screening from 50 to 74 (strong recommendation). However, in the absence of data on the role of BSE in patients aged over 75, those at high risk of breast cancer and those previously treated for breast cancer, the CS was unable to issue recommendations. Thus, if women in these latter categories wish to undergo BSE, they must be given rigorous training in the technique, and information on the benefits and risks observed in the general population. Finally, the CS invites all women who detect a change or abnormality in their breasts to consult a healthcare professional without delay., Conclusion: BSE is not recommended for women in the general population. No recommendation can be established for women aged over 75, those at high risk of breast cancer and those previously treated for breast cancer., (Copyright © 2023 CNGOF. Published by Elsevier Masson SAS.. All rights reserved.)

Copyright of Médiévales is the property of Presses Universitaires de Vincennes and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The physiological ageing, the chronic conditions and the psycho-social environment are source of vulnerability to the old subject. These factors impact on the oral pathologies while the oral affections can deteriorate them on the contrary and lead the patient in the spiral of the decompensation. The clinical examination has to consist of a global approach of the eldely person, what confers it a specific character. Within the framework of this article, we propose a methodology of diagnostic survey bringing to light the necessity of interdisciplinary collaboration between the medical participants. [ABSTRACT FROM AUTHOR]

Copyright of Lettre de Medecine Physique et de Readaptation is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: Purpose: Diagnosis of fever of unknown origin (FUO) is a major challenge for internists, as emphasized by the high rate of diagnostic failure, despite the fast-moving progress in medical technology. Numerous clues are available in clinical and standard biological data; a better use of the available tests is warranted. Key points: Improvement in diagnostic accuracy might be expected by developing strategies targeted toward a more systematic search of diagnosis clues. Intuition and the hypothetic – deductive method that are the most common clinical strategies are the most perfectible. It implies to enjoy the fun of clinical examination, to have a large experience in bedside training, to be confident in his/her own semiological skills, to refer frequently to heuristics, and to use carefully Occam''s razor principle. Laboratory tests might be revisited; immunological and serological tests are of little value; standard biological tests provide many insufficiently exploited clues. Imaging procedures depend on objectives: whole body CT scan should be performed early within the first days of hospitalisation, preceded by standard chest radiograph and abdomen ultrasonography; followed by either indium-111 or technetium-99m, labelled leukocytes if deep abscesses are suspected or 18-FDG PET scan in the case of suspected inflammatory disease involving tissues, lymph nodes or arteries. Early identification of the best tissue to be the site of biopsy is one of the most decisive procedures. Conclusion: Strategies and tactical approaches for the diagnosis of FUO might be driven by the search of significant clues. Self-clinical experience driven by a wide bedside training is of major concern. Standard laboratory tests might be better used and the choice of imaging depends on objectives. Identification of the most appropriate tissue to be sampled for histological examination is one of the most beneficial step. [Copyright &y& Elsevier]

Copyright of EMC-Odontologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of EMC-Cardiologie-Angeiologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of EMC-Psychiatrie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Andrologie (11662654) is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Pelvi-Perineologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: The objective was to evaluate the diagnostic value of clinical examination and complementary imaging in the exploration of a breast lump or microcalcifications occurring in a postmenopausal woman taking hormonal replacement therapy (HRT), based on a systematic review of the literature in order to make recommendations for HRT management., Methods: A literature review was conducted using Medline, Cochrane Library data and international recommendations in French and English until 2020., Results: In the presence of a clinical breast mass in postmenopausal women, there is no clinical evidence to rule out cancer. A double evaluation by mammography and ultrasound is recommended and allows the imaging to be classified into 5 BI-RADS categories. The diagnostic management of masses classified BI-RADS 4 and 5 should be based on percutaneous sampling, with microbiopsy being the first step. A total of four situations may arise: 1. Clinical examination has detected a breast mass, but there is no imaging abnormality. In this case, the imaging NPV is high (>96%). If the clinical lesion increases in size, a tissue biopsy should be performed, while continued routine breast screening is recommended if the lesion remains stable and HRT can be continued. 2. Clinical examination, mammography, and ultrasound are in favour of a cyst. Simple cysts can be punctured if painful. There is no contraindication to continuing HRT in the case of simple cysts. Management options for complicated and complex cysts are no different from those offered to women without HRT. Continuation of HRT must consider their histological nature. 3. Clinical examination, mammography, and ultrasonography suggest a benign solid tumour. The management of these benign breast lesions (fibroadenoma…) is not different in women taking an HRT and there is no contraindication to continue the HRT. 4: Clinical examination, imaging and microbiopsy diagnose a malignant tumour. It is imperative that the HRT be stopped, whatever the hormonal dependence of the tumour and whether it is invasive or in situ. The management of the cancerous tumour must consider the updated breast cancer treatment guidelines. In the presence of microcalcifications, the course of action to be taken depends on the BI-RADS classification, established according to the morphology and arrangement of the calcifications. In case of suspicious microcalcifications (BI-RADS 4 or 5), a guided macrobiopsy should be performed. Diagnostic and therapeutic management in these patients is no different from that offered to women without HRT. Discontinuation of HRT is necessary in cases of malignancy (in situ or invasive cancer)., Conclusion: A rigorous multidisciplinary approach is necessary for the exploration of a breast mass or microcalcifications in a postmenopausal woman., (Copyright © 2021. Published by Elsevier Masson SAS.)

The writer rebels in a mood ticket on the dictatorship of the complementary examinations at the expense of the clinical approach. She comments on the multiple reasons, medical and medicolegal, which in the 21st century still encourages a good history taking and a good clinical examination.

Strokes are a significant issue in geriatric medicine as more than half occur in patients over the age of 75. However, not all the symptoms of a focal neurological deficit in the elderly are indicative of a stroke. There are a number of differential diagnoses and only a detailed examination of the patient can enable an accurate diagnosis to be established. However, in no case must this delay the urgent treatment of the patient suspected of having a stroke., (Copyright © 2019 Elsevier Masson SAS. All rights reserved.)

Copyright of Colon & Rectum is the property of Lavoisier and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Lettre de Medecine Physique et de Readaptation is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: The aim of the study was to assess the diagnostic value of physical examination, radiologic explorations and percutaneous procedures of the breast in the exploration of a non-inflammatory palpable mass, in order to propose guidelines., Method: A systematic literature review was conducted in the Medline and Cochrane library databases. International guidelines in French and English language were also consulted until April 30th 2015., Results: Physical examination of a non-inflammatory palpable breast mass is not sufficient to eliminate a breast cancer (LE2). Mammography alone has a sensitivity between 70 and 95% for the diagnosis of breast cancer (LE3). Echography alone has a sensitivity of 98 to 100% for the diagnosis of breast cancer (LE2). The core needle biopsy has a better sensitivity and specificity than the fine-needle aspiration for breast cancer diagnosis (LE2). The association of mammography and 2D echography presents excellent sensitivity and negative predictive value (close to 100 %) to exclude a breast cancer (LE3). A double evaluation using mammography and echography is recommended in the exploration of a non-inflammatory palpable breast mass (grade B)., (Copyright © 2015 Elsevier Masson SAS. All rights reserved.)

Summary: The authors reviewed the different components of the clinical assessment of patients with common sciatica. They searched the literaturefor the specificity, sensitivity, reproductibility, predictive value and significance of each of these elements. The presence of a trunk list could result from a high pressure by the hernia on the root. A lumbar stiffness in flexion would increase the likeliness of a root compression. The reproduction of the sciatica by lumbar extension could evoke a foraminal stenosis. The Lasegue sign has a good sensitivity, but a poor specificity to predict the presence of a disc herniation on imaging tests. Abolition of the ankle reflex is significant of a S 1 root involvement. [Copyright &y& Elsevier]