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Auscultation

Q: What are the different techniques and methods used in auscultation?

Auscultation can be performed using a variety of techniques and methods. The most common approach is the use of a stethoscope, which allows healthcare providers to listen to internal bodily sounds such as heart beats, breath sounds, and bowel sounds. However, there are also other auscultation methods, including the use of electronic stethoscopes, phonocardiography, and lung sound analysis software. Each technique has its own advantages and can be selected based on the specific clinical needs and the provider's expertise.

Q: How can PubCompare.ai help optimize auscultation research?

PubCompare.ai is a powerful tool that can assist researchers in optimizing their auscultation studies. The platform allows you to efficiently screen protocol literature, leveraging advanced AI-driven analysis to pinpoint critical insights. By utilizing PubCompare.ai, researchers can identify the most effective auscultation protocols for their specific research goals, helping to enhance the reproducibility and accuracy of their findings. The platform's AI-driven comparisons can highlight key differences in protocol effectiveness, enabling researchers to choose the best option for their studies.

Q: How does auscultation contribute to accurate medical diagnosis?

Auscultation is a critical skill in medical practice, as it allows healthcare providers to assess cardiovascular, respiratory, and other physiological functions. By listening to internal bodily sounds, providers can detect abnormalities that may indicate underlying health conditions. Proper technique and interpretation of auscultatory findings are essential for accurate diagnosis and effective treatment. For example, the detection of heart murmurs or abnormal breath sounds can lead to further investigations and the identification of cardiovascular or pulmonary disorders. Auscultation, when combined with other clinical assessments, helps healthcare providers make more informed decisions and provide better patient care.

Q: What are some of the latest advancements in auscultation technology?

The field of auscultation is constantly evolving, with ongoing research and development of new technologies to enhance the reproducibility and accuracy of this critical medical skill. Some of the latest advancements include: 1. Electronic stethoscopes: These devices incorporate digital sensors and signal processing algorithms to amplify and analyze internal bodily sounds, providing more detailed and objective data for interpretation. 2. Lung sound analysis software: Specialized software can digitize and analyze lung sounds, helping to identify patterns and abnormalities that may be difficult for the human ear to detect. 3. Artificial intelligence (AI) and machine learning: AI-powered algorithms are being developed to assist healthcare providers in the interpretation of auscultatory findings, potentially improving diagnostic accuracy and consistency. These technological advancements, coupled with PubCompare.ai's ability to help researchers identify the most effective auscultation protocols, are driving the field of auscultation forward and enhancing patient care.

Auscultation is the act of listening to internal bodily sounds, typically using a stethoscope.
It is a critical skill in medical practice, allowing healthcare providers to assess cardiovascular, respiratory, and other physiological functions.
This non-invasive technique involves placing a stethoscope on the patient's skin to detect and interpret various sounds, such as heart beats, murmurs, breath sounds, and bowel sounds.
Auscultation requires extensive training and experience to accurately identify abnormal findings that may indicate underlying health conditions.
Proper technique and interpretation of auscultatory findings are essential for accurate diagnosis and effective treatment.
Reserach into auscutlation methods and devices is ongoing to enhance reproducibility and accuracy in clinical practice.

Most cited protocols related to «Auscultation»

Comparative Analysis of Blood Pressure Measurement Methods

Several BP measurement methods are now available. The main methods include catheterization, auscultation, oscillometry, volume clamping, and tonometry.
Catheterization is the gold standard method [6 (link)]. This method measures instantaneous BP by placing a strain gauge in fluid contact with blood at any arterial site (e.g., radial artery, aorta). However, the method is invasive.
Auscultation, oscillometry, and volume clamping are noninvasive methods. These methods employ an inflatable cuff.
Auscultation is the standard clinical method [7 (link)]. This method measures systolic and diastolic BP by occluding an artery with a cuff and detecting the Korotkoff sounds using a stethoscope and manometer during cuff deflation. The first sound indicates the initiation of turbulent flow and thus systolic BP, while the fifth sound is silent and indicates the renewal of laminar flow and thus diastolic BP.
Oscillometry is the most popular non-invasive, automatic method [8 (link), 9 (link)]. This method measures mean, diastolic, and systolic BP by also using a cuff but with a pressure sensor inside it. The measured cuff pressure not only rises and falls with cuff inflation and deflation but also shows tiny oscillations indicating the pulsatile blood volume in the artery. The amplitude of these oscillations varies with the applied cuff pressure, as the arterial elasticity is nonlinear. The BP values are estimated from the varying oscillation amplitudes using the empirical fixed-ratios principle. When evaluated against auscultation using an Association for the Advancement of Medical Instrumentation (AAMI) protocol, some oscillometric devices achieve BP errors within the AAMI limits of 5 mmHg bias and 8 mmHg precision [10 ]. However, oscillometry is unreliable in subjects with certain conditions such as atrial fibrillation, stiff arteries, and pre-eclampsia [11 ].
Volume clamping is a non-invasive, automatic method used in research [12 (link), 13 ]. This method measures instantaneous (finger) BP by using a cuff and a photoplethysmography (PPG) sensor to measure the blood volume (see Section V.A). The blood volume at zero transmural pressure is estimated via oscillometry. The cuff pressure is then continually varied to maintain this blood volume throughout the cardiac cycle via a fast servo-control system. The applied cuff pressure may thus equal BP. Volume clamping devices also achieve BP errors within AAMI limits when evaluated against auscultation and near AAMI limits when evaluated against radial artery catheterization [14 (link)].
However, cuff use has several drawbacks. In particular, cuffs are cumbersome and time consuming to use, disruptive during ambulatory monitoring, especially while sleeping, and do not readily extend to low resources settings.
Tonometry is another non-invasive method used in research that, in theory, does not require an inflatable cuff [15 , 16 ]. This method measures instantaneous BP by pressing a manometer-tipped probe on an artery. The probe must flatten or applanate the artery so that its wall tension is perpendicular to the probe. However, manual and automatic applanation have proven difficult. As a result, in practice, the measured waveform has been routinely calibrated with cuff BP whenever a BP change is anticipated [17 (link)].
In sum, the existing BP measurement methods are invasive, manual, or require a cuff. So, none are suitable for ubiquitous (i.e., ultra-convenient, unobtrusive, and low cost) monitoring.

Mukkamala R., Hahn J.O., Inan O.T., Mestha L.K., Kim C.S., Töreyin H, & Kyal S. (2015). Towards Ubiquitous Blood Pressure Monitoring via Pulse Transit Time: Theory and Practice. IEEE transactions on bio-medical engineering, 62(8), 1879-1901.

Publication 2015

Aorta Arteries Arteries, Radial Atrial Fibrillation Auscultation BLOOD Blood Pressure Blood Volume Cardiac Volume Catheterization Clinical Protocols Diastole Elasticity Fingers Gold Manometry Medical Devices Oscillometry Photoplethysmography Pre-Eclampsia Pressure Pressure, Diastolic Sound Stethoscopes Strains Systole Systolic Pressure Tonometry

Measuring Blood Pressure: From Invasive to Noninvasive

The first quantitative measurements of blood pressure were performed in animals by Hales in 1733 [24 , 25 (link)]. Early reports of intra-arterial pressure measurement in the human are from 1912, when Bleichröder [26 ] cannulated his own radial artery. It is unlikely that he recorded his BP although it would have been possible at that time: Frank developed accurate and fast manometers that could measure pulsatile pressure in 1903 [27 ]. Invasive measurement of BP was confined to the physiology labs for quite some time [28 (link), 29 (link)]. However in the 1950s and 1960s, with the development of refined insertion techniques [30 (link)] and Teflon catheters it became standard clinical practice. High fidelity catheter-tip manometers, such as used to measure pressure gradients across a coronary stenosis, were introduced by Murgo and Millar in 1972 [31 ]. Table 1 gives an overview of BP methods.Table 1

Methods for measurement of blood pressure and cardiac output

System	Method	Company	CO		BP
Nexfin	Finger cuff technology/pulse contour analysis	BMEYE	+	___	+	___
Finometer	Finger cuff technology/pulse contour analysis	FMS	+	___	+	___
LIFEGARD^® ICG	Thoracic electrical bioimpedance	CAS Medical Systems, Inc.	+	___	+	…
BioZ Monitor	Impedance cardiography	CardioDynamics International Corporation	+	___	+	…
Cheetah reliant	“Bioreactance”	Cheetah Medical	+	___	+	…
Cardioscreen/Niccomo	Impedance cardiography and impedance plethysmography	Medis Medizinische Messtechnik GmbH	+	___	+	…
AESCULON	Electrical “velocimetry”	Osypka Medical GmbH	+	___	+	…
HIC-4000	Impedance cardiography	Microtronics Corp Bio Imp Tech, Inc.	+	___
NICaS	Regional impedance	NImedical	+	___
IQ2	3-dimensional impedance	Noninvasive Medical Technologies	+	___
ICON	Electrical “velocimetry”	Osypka Medical GmbH	+	___
PHYSIO FLOW	Thoracic electrical bioimpedance	Manatec biomedical	+	___
AcQtrac	Thoracic impedance	Väsamed	+	___
esCCO	Pulse wave transit time	Nihon Kohden	+	___
TEBCO	Thoracic electrical bioimpedance	HEMO SAPIENS INC.	+	___
NCCOM 3	Impedance cardiography	Bomed Medical Manufacturing Ltd	+	___
RheoCardioMonitor	Impedance cardiography	Rheo-Graphic PTE	+	___
HemoSonic™ 100	transesophageal Doppler	Arrow Critical Care Products	+	___
ECOM	Endotracheal bioimpedance	ConMed Corporation	+	___
CardioQ-ODM™	Oesophageal Doppler	Deltex	+	___
TECO	Transesophageal Doppler	Medicina	+	___
ODM II	Transesophageal Doppler	Abbott	+	___
HDI/PulseWave™ CR-2000	Pressure waveform analysis	Hypertension Diagnostics, Inc	+	_ _	+	_ _
USCOM 1A	Transthoracic Doppler	Uscom	+	_ _
NICO	Rebreathing Fick	Philips Respironics	+	…
Innocor	Rebreathing Fick	Innovision A/S	+	…
Vigileo/FloTrac	Pulse contour analysis	Edwards Lifesciences	–	___	–	___
LiDCOplus PulseCO	Transpulmonary lithium dilution/pulse contour analysis	LiDCO Ltd	–	___	–	___
PiCCO2	Transpulmonary thermodilution/pulse contour analysis	PULSION Medical Systems AG	–	___	–	___
MOSTCARE PRAM	Pulse contour analysis	Vytech	–	___	–	___
Vigilance	Pulmonary artery catheter thermodilution	Edwards Lifesciences	–	…	–	___
DDG	Dye-densitogram analyzer	Nihon Kohden	–	…
Truccom	Pulmonary artery catheter thermodilution	Omega Critical Care	–	…
COstatus	Ultrasound dilution	Transonic Systems Inc.	–		+	…
CNAP Monitor 500	Finger cuff technology	CNSystems Medizintechnik AG			+	___
SphygmoCor^® CPV System	Applanation tonometry	AtCor Medical			+	_ _
TL-200 T-LINE	Applanation tonometry	Tensys Medical, Inc.			+	_ _

+ noninvasive, – invasive, ___ continuous, _ _ semi-continuous, … intermittent

Practical noninvasive (intermittent) BP measurement became possible when Riva-Rocci presented his air-inflatable arm cuff connected to a manometer in 1896 [32 , 33 (link)]. By deflating the cuff and feeling for the pulse, systolic BP could be determined. In 1905 Korotkoff [34 , 35 (link)] advanced the technique further with the auscultatory method making it possible to determine diastolic pressure as well. In 1903 Cushing recommended BP monitoring using the Riva-Rocci sphygmomanometer for patients under general anesthesia [36 (link)]. Nowadays, automated assessment of BP with oscillometric devices is commonly used. These devices determine BP by analyzing the oscillations measured in the cuff-pressure. The pressure in the cuff is first brought above systolic pressure and then deflated to below diastolic pressure. Oscillations are largest when cuff pressure equals mean arterial pressure. Proprietary algorithms determine systolic and diastolic values from the oscillations. Oscillometers may be inaccurate [37 ], and provided values that are frequently lower than direct BP measurements in critically ill patients, [38 (link), 39 (link)] whereas detection of large BP changes is unreliable [40 (link)]. Due to its intermittent nature hyper- and hypotensive periods may be missed [2 (link)].
“Semi-continuous noninvasive methods” based on radial arterial tonometry require an additional arm cuff to calibrate arterial pressure [41 (link)–43 (link)]. The use of these devices may become problematic under conditions with significant patient motion or surgical manipulation of the limbs [43 (link), 44 (link)]. However, tonometry devices have contributed greatly to the knowledge of the relation between the pressure wave shape and cardiovascular function [45 (link), 46 (link)].

Truijen J., van Lieshout J.J., Wesselink W.A, & Westerhof B.E. (2012). Noninvasive continuous hemodynamic monitoring. Journal of Clinical Monitoring and Computing, 26(4), 267-278.

Publication 2012

Animals Arteries Arteries, Radial Auscultation Cardiovascular Physiological Phenomena Catheters Cheetahs Coronary Stenosis Critical Care Critical Illness Determination, Blood Pressure Diagnosis Diastole Electricity Esophagus General Anesthesia Heart Homo sapiens Lithium Manometry Medical Devices Operative Surgical Procedures Oscillometry Patients physiology Pressure Pressure, Diastolic Pulse Rate Reliance resin cement Sphygmomanometers Systole Systolic Pressure Technique, Dilution Teflon Thermodilution Tonometry Velocimetry

Pediatric Ambulatory Blood Pressure Monitoring

For more detail on equipment used in ABPM, refer to the 2008 AHA scientific statement.^{3 (link)} Briefly, both oscillometric and auscultatory monitors are available for use in pediatric ABPM.^{111 (link),115 (link)} Many monitors are available and have been evaluated with use of the Association for the Advancement of Medical Instrumentation US national standard or the British Hypertension Society standard.^{128 ,129} A comprehensive list noting validation status is available online at www.dableducational.org. Unfortunately, monitors that have not undergone validation testing or US Food and Drug Administration clearance can be sold in the United States, and few have been formally validated in children.^{130 (link)} Child-specific issues include the need for lightweight devices appropriate for smaller bodies, proper cuff sizing to ensure that the cuff width is ≈40% of the midarm circumference, and device tolerance of excessive motion.^{101a (link)} For auscultatory devices, users should ascertain whether the fourth or fifth Korotkoff sound is being used to estimate DBP and should be aware that no normative data are available for auscultatory ABPM.^{131 (link),132 (link)} Although oscillometric devices may be easier to use and have fewer erroneous readings, oscillometric BP measurement also has inherent limitations, as reflected in the generally lower ratings on British Hypertension Society protocol evaluation.^{108 (link)} Nevertheless, most centers that perform ABPM in children and adolescents use oscillometric devices. These issues are summarized in Table 1.

Flynn J.T., Daniels S.R., Hayman L.L., Maahs D.M., McCrindle B.W., Mitsnefes M., Zachariah J.P, & Urbina E.M. (2014). Update: Ambulatory Blood Pressure Monitoring in Children and Adolescents: A Scientific Statement From the American Heart Association. Hypertension, 63(5), 1116-1135.

Publication 2014

Adolescent Auscultation Child Food High Blood Pressures Human Body Immune Tolerance Medical Devices Oscillometry SELL protein, human Sound

Standardized Auscultatory Blood Pressure Measurement Protocol

CKiD participants have casual BP measurements obtained in the right arm by auscultation at study entry (baseline), then annually thereafter. All participating sites have been provided the same aneroid sphygmomanometer (Mabis MedicKit 5, Mabis Healthcare, Waukegan, IL) by the CKiD Clinical Coordinating Centers (CCC's). The CCC's also provide standardized training and certification in the auscultatory BP measurement protocol described below to all study personnel responsible for casual BP measurement. Recertification in auscultatory BP measurement technique and calibration of each center's aneroid device takes place annually.
At each study visit, prior to BP determination, arm circumference is measured (in centimeters) with a plastic measuring tape at the midpoint of the upper arm between the amicron and olecranon and a cuff is then selected so that the length of the cuff bladder is equal to 80-100% of the arm circumference^{6 (link)}. Following cuff selection, the peak inflation pressure is determined by inflating the cuff to 60 mmHg and then gradually continuing to inflate in increments of 10 mmHg until the radial pulse is no longer felt – thereby determining the pulse obliteration pressure. An additional 30 mmHg is added to this value and recorded as the peak inflation pressure. The cuff is then inflated to this value for all BP measurements at that study visit.
After 5 minutes of rest, BP measurement begins. Participants are instructed to refrain from caffeine intake, smoking, and exercise at least one half hour prior to and until completion of BP measurement. They are also instructed to refrain from playing video games, using a cell phone, or other activities that may affect BP until all measurements are obtained. First, pulse is measured by palpation of the radial artery. Then three BP measurements at 30-second intervals are obtained by auscultation of the brachial artery, using the first Korotkoff sound for systolic BP (SBP) and the fifth Korotkoff sound for diastolic BP (DBP). The average of the 3 BP measurements is recorded as the participant's BP for the study visit. Participants' BP's so obtained at the baseline visit are included in the present study.

Flynn J.T., Mitsnefes M., Pierce C., Cole S.R., Parekh R.S., Furth S.L, & Warady B.A. (2008). Blood Pressure in Children with Chronic Kidney Disease: A Report from the Chronic Kidney Disease in Children Study. Hypertension, 52(4), 631-637.

Publication 2008

Arteries, Radial Auscultation BP protocol Brachial Artery Caffeine Feelings Medical Devices methyl 4-azidobenzimidate Olecranon Process Palpation Pressure Pressure, Diastolic Pulse Pressure Pulse Rate Sound Sphygmomanometers Systolic Pressure Urinary Bladder

Maternal Characteristics and Birth Outcomes

Among the final sample (n = 1413) information on maternal weight at the time of birth was missing in 8.6% (n = 122), and information on height in 11.0% (n = 156) of women. We assumed that missing data had occurred at random, i.e., that missings were not influenced by unobserved data. We applied imputation procedures using the average of five iterations with IVEware [21 ]. Imputation of maternal height was based on migration status and age; imputations of maternal weight were based on migration status, age, and height. Results of an analysis without imputed data do not differ substantially from the results given in Table 1 and Table 2 (see appendix, Table 4 and Table 5).Table 1

Characteristics of the selected subsample of women, by migration status

	Turkish origin	Lebanese origin	Non-immigrants
N	133	72	1208
Age in years ^{*** 1)}
Median (range)	25 (18–45)	24 (18–41)	30 (18–44)
Highest educational level (%) ^{*** 2)}
No qualification/primary school	36 (27.1%)	14 (19.4%)	28 (2.3%)
Secondary school	72 (54.1%)	34 (47.2%)	530 (43.9%)
University / technical collage / vocational school / a-level vocational diploma	25 (18.8%)	24 (33.3%)	650 (53.8%)
Body Mass Index at admission (%) ^{n.s. 2)}
BMI < 25 kg/m²	17 (12.8%)	17 (23.6%)	235 (19.5%)
BMI < 30 kg/m²	66 (49.6%)	28 (38.9%)	546 (45.2%)
BMI ≥30 kg/m²	50 (37.6%)	27 (37.5%)	427 (35.4%)
Oxytocic agent ^{n.s. 2)}
Yes (%)	74 (55.6%)	33 (45.8%)	611 (50.6%)
Cervical dilatation ^{* 2)}
Median (range) in cm	2 (0–8)	2 (0–10)	2 (0–10)
Active phase of labor (≥4 cm) in %	21 (15.8%)	19 (26.4%)	315 (26.1%)
Delivery mode (%) ^{** 2)}
Normal vaginal delivery	75 (56.4%)	52 (72.2%)	685 (56.7%)
Vacuum extraction / forceps	37 (27.8%)	10 (13.9%)	234 (19.4%)
Emergency cesarean delivery	21 (15.8%)	10 (13.9%)	289 (23.9%)
Obstetric complications	All participants (1403)
HELLP-Syndrome		6 (0.4%)
Eclampsia		0
Hemorrhage > 1000 ml		23 (1.6%)
Sepsis		0
Cardiovascular complications		0
Uterine rupture		< 5 **

* p < 0.05, ** p < 0.01, *** p < 0.001

1) Kruskal-Wallis test

2) Chi-square test

^** no detailed data due to data protection

Table 2

Indications for cesarean delivery

Rank	Turkish origin	N (%)	Lebanese origin	N (%)	Non-immigrant women	N (%)
1	Pathological CTG or auscultatory bad fetal heart tones	40 (30.1)	Pathological CTG or auscultatory bad fetal heart tones	17 (23.6)	Pathological CTG or auscultatory bad fetal heart tones	317 (26.8)
2	Protracted labor/obstructed labor in the expulsion stage	18 (13.5)	Green amniotic fluid	5 (6.9)	Protracted labor/obstructed labor in the expulsion stage	148 (12.3)
3	Protracted labor/obstructed labor in the dilation stage	9 (6.8)	Chorioamnionitis syndrome	4 (6.0)	Protracted labor/obstructed labor in the dilation stage	72 (6.6)
4	Chorioamnionitis syndrome	6 (4.5)	Protracted labor/obstructed labor in the dilation stage	4 (6.0)	Green amniotic fluid	43 (3.6)
5	Green amniotic fluid	3 (2.3)	Protracted labor/obstructed labor in the expulsion stage	4 (6.0)	Absolute or relative imbalance between child‘s head and mother‘s pelvis	29 (2.4)

Category “other birth risks” was not considered

Breckenkamp J., Läcke E.M., Henrich W., Borde T., Brenne S., David M, & Razum O. (2019). Advanced cervical dilatation as a predictor for low emergency cesarean delivery: a comparison between migrant and non-migrant Primiparae – secondary analysis in Berlin, Germany. BMC Pregnancy and Childbirth, 19, 1.

Publication 2019

Amnion Auscultation Birth Cardiovascular System Care, Prenatal Child Chorioamnionitis Dilatations, Cervical Emergencies Fetal Heart Head Heart Auscultation HELLP Syndrome Hemorrhage Immigrants Index, Body Mass Mothers Obstetric Delivery Obstetric Labor Oxytocics Pathological Dilatation Uterine Rupture Vacuum Extraction, Obstetrical Vagina Woman

Most recents protocols related to «Auscultation»

Pediatric Congenital Heart Disease Evaluation

In this cross-sectional study, 1272 pediatric patients under 16 years who were referred for follow-up of a known congenital heart defect (before or after a corrective surgery) or for evaluation of a possible congenital heart disease between April 2021 and February 2022, to a pediatric cardiology clinic in Mofid Children Hospital, Tehran, Iran were enrolled. Characteristics of the patients, including their medical histories and diagnosis, were obtained from the parents and if needed from the electronic medical record system of our center. All the patients were examined by a single experienced pediatric cardiologist using a conventional stethoscope at the first step and a Doppler Phonolyser device at the second step. In this regard, while the patient was in the supine position, an Ultrasound 2 MHz probe of a Doppler Phonolyser device was firmly secured on the chest for 30 s in each of four usual auscultatory areas. The Doppler Phonolyser’s results were interpreted based on the Doppler graph (Fig. 2). A checklist in which the patients were classified based on the auscultation findings as well as Doppler Phonolyser findings in three groups (normal, innocent murmur and pathologic murmur) was completed. A second pediatric cardiologist blindly re-examined 120 patients of the total patients with the Doppler Phonolyser device and the findings were recorded in a second checklist. Afterward, the patient underwent trans-thoracic echocardiography with either a GE Vivid S60 or a Samsung HS70 echocardiographic system. The echocardiogram was interpreted without the knowledge of Doppler Phonolyser results. The echocardiogram was considered normal if there was no pathologic finding other than mild tricuspid or pulmonary regurgitation.
Consent for participation was obtained from the parents of the participants and the protocol was conducted in compliance with the Declaration of Helsinki and approved by the Ethical committee of Shahid Beheshti University of Medical Science (Ethics approval number: IR.SBMU.MSP.REC.1400.641).

Khalilian M.R., Safari M., Hajipour M., Rahmani K., Safari M., Ahmadpour M.H, & Tahouri T. (2023). Evaluation of the heart sounds in children using a Doppler Phonolyser. BioMedical Engineering OnLine, 22, 24.

Publication 2023

Auscultation Cardiologists Cardiovascular System Chest Child Congenital Heart Defects Diagnosis Echocardiography Medical Devices Operative Surgical Procedures Parent Patients Pulmonary Valve Insufficiency Stethoscopes Ultrasounds, Doppler

Deer Fipronil Exposure Protocol

At the conclusion of the tick observations on day 8 post-attachment, fresh fecal samples were collected from each test deer pen. Additionally, internal tissues were collected from each deer in each treatment group. The deer were first sedated by injection of 1–2 mg/kg xylazine hydrochloride (100 mg/ml) into the large muscle bellies of the rump/rear limbs. While sedated, deer were euthanized by intravenous injection, administered via the jugular vein, of 86 mg/kg Euthasol (pentobarbital sodium, 390 mg/ml), resulting in pentobarbital sodium overdose. Death was confirmed by a combination of the following: (i) lack of heartbeat based on auscultation with a stethoscope; (ii) lack of respiration based on visual inspection of the thorax; (iii) lack of corneal reflex; and (iv) lack of response to firm toe pinch. All euthanasia was performed by the attending veterinarian exclusively.
Various tissues were collected from euthanized deer. The objective was to collect tissues similar to what would be collected by hunters when field dressing a killed deer. Thus, we focused on specific meat cuts, meat by-products and fatty tissues. Approximately 50 g of each tissue was surgically removed using disposable scalpels. Scalpels and surgical gloves were replaced between each individual tissue collection to minimize the risk of contamination. Each tissue was transferred to an individual biological specimen bag (Keefitt®), which was immediately stored at − 20 °C until analysis. In addition to collecting tissues from 16 deer in the treatment group, we collected tissues from two deer in the control group to establish a baseline and for analytical method development.
Tissues, plasma and feces were delivered to CSU for method development and analyses, and analyzed for the presence of fipronil and fipronil metabolites using validated methods of liquid chromatography/mass spectrometry (LC/MS). A list of tissue classifications, the maximum residue limits (MRL) listed by the US Environmental Protection Agency (EPA) for fipronil in cattle and the explicit tissue identifications are presented in Additional file 6: Table S2.
Critical study dates for each test deer (acclimation, exposure, post-attachment, capsule checks, tissue collection) are presented in Additional file 7: Table S3.

Poché D.M., Wagner D., Green K., Smith Z., Hawthorne N., Tseveenjav B, & Poché R.M. (2023). Development of a low-dose fipronil deer feed: evaluation of efficacy against two medically important tick species parasitizing white-tailed deer (Odocoileus virginianus) under pen conditions. Parasites & Vectors, 16, 94.

Publication 2023

Acclimatization Auscultation Biopharmaceuticals Capsule Cattle Cell Respiration Chest Corneal Reflexes Deer Drug Overdose Euthanasia Feces fipronil Jugular Vein Liquid Chromatography Mass Spectrometry Meat Meat Products Muscle Tissue Operative Surgical Procedures Pentobarbital Sodium Plasma Pulse Rate Stethoscopes Ticks Tissue, Adipose Tissues Veterinarian Xylazine Hydrochloride

Fetal Echocardiography for Cardiac Abnormalities

Fetal echocardiography was performed by cardiac ultrasound specialists when abnormal auscultation of the fetal heart was detected at antenatal visits or during ultrasonographic examination.^{[8 (link),12 (link)]} Fetal cardiac function was also assessed using the fetal cardiovascular profile score that encompassed fetal-hydrops, abnormal venous and arterial Doppler findings, cardiomegaly, atrioventricular valve regurgitation, and cardiac dysfunction; each component was scored 1 to 2 points according to ultrasonographic examination.^{[13 (link)]}Fetal-hydrops was defined as the accumulation of abnormal fluid in at least 2 different fetal compartments, and included pleural effusion, pericardial effusion, and peritoneal effusion; skin edema (skin thickness > 5 mm); thickened placenta (≥4 cm in the second trimester or ≥ 6 cm in the third trimester); or polyhydramnios.^{[14 (link),15 (link)]} Fetal-hydrops was monitored every other 3-to-5-day period during pregnancy according to the intrauterine state of the arrhythmic fetus.^{[16 (link)]}

Hu Q., Liao H., Xu T., Liu H., Wang X, & Yu H. (2023). Perinatal outcomes of intrauterine fetal arrhythmias: A 10-year retrospective cohort study. Medicine, 102(10), e33244.

Publication 2023

Arteries Auscultation Cardiovascular System Care, Prenatal Echocardiography Edema Effusion, Pericardial Fetal Heart Fetus Heart Heart Auscultation Heart Failure Hydrops Fetalis Peritoneal Effusion Placenta Pleural Effusion Polyhydramnios Pregnancy Skin Specialists Ultrasonography Veins

Coagulation Dysfunction Predicts Acute Kidney Injury

All the data were divided into two categories: continuous variables and categorical data. The measurement data are expressed as the mean ± SD or median [interquartile range (IQR)]. Categorical data are expressed as the number (percentage). Continuous variables were analyzed using Student t test, and categorical variables were analyzed using chi-squared or Fisher exact test. To estimate the coagulation dysfunction of AKI and malignant events, odds ratios (ORs) and 95% CIs were calculated with univariable analysis and multivariable adjustments in the following models to reduce the effect of known possible confounders: model 1—adjusted for age, gender, acute aortic dissention (Stanford classification), smoking history, drinking history, systolic blood pressure (SBP), diastolic blood pressure (DBP), and comorbidities (including hypertension, Marfan syndrome, heart surgery history, arteriosclerosis, coronary heart disease, aortic valve disease, and diabetes mellitus type 2); model 2—adjusted model 1 + murmur in the aortic valve auscultation area, organ or limb ischemia, hypotensive shock, number of renal arteries involved, aneurysm on imaging, ulcer of the aorta, and aortic intermural hematoma; and model 3—adjusted model 2 + white blood cell count.
In addition, propensity score matching (PSM), using nearest-neighbor matching (1:1) within a caliper width of 0.02 SD without replacement, was performed between the coagulation dysfunction groups based on the estimated propensity scores. Furthermore, to confirm the robustness of the results, PSM was performed on the same results as a sensitivity analysis.
To further clarify the contribution rate of each coagulation indicator, chi-squared or Fisher exact test was used to compare the dysfunction of each coagulation indicator across the different prognosis groups. Receiver operating characteristic (ROC) curve analysis was then used to evaluate the value of each coagulative indicator and ACS for predicting the in-hospital AKI and malignant events.
Statistical analyses were performed with SPSS version 27.0 and PASS version 15. A two-sided P value of <0.05 was considered to denote the presence of a statistically significant difference.

Jiang S., Li Y., Li C., Shu Z., Wu S., Lu X., Liu Y., Deng Y., Chen Y., Cai P, & Wang B. (2023). The association of coagulation indicators with in-hospital acute kidney injury and malignant events of patients with acute aortic dissection: a retrospective cohort study. Journal of Thoracic Disease, 15(2), 658-667.

Publication 2023

Aorta Aortic Aneurysm Arteriosclerosis Auscultation Coagulation, Blood Diabetes Mellitus, Non-Insulin-Dependent Gender Heart Disease, Coronary Hematoma High Blood Pressures Hypersensitivity Ischemia Leukocyte Count Marfan Syndrome Pressure, Diastolic Prognosis Renal Artery Shock Student Surgical Procedure, Cardiac Systolic Pressure Ulcer Valve Disorder, Aortic Valves, Aortic

Remote Cardiac Auscultation Evaluation

This was an open-label randomized controlled pilot study. This research was designed to evaluate the utility of the phonocardiogram in remote cardiac auscultation. Remote auscultation using an internet connection was used as a control. For standardization and reliability, a cardiology patient simulator for cardiac auscultation was used.^{6 (link)} All sessions in this research were conducted at the skills lab and the research room in the Department of Diagnostic and Generalist Medicine, Dokkyo Medical University. The direct distance between the two places is approximately 200 m. Attending physicians and senior residents in the Department of Diagnostic and Generalist Medicine and junior residents in the university hospital were recruited as the participants. Attending physicians, senior residents, and junior residents were classified according to the years since obtaining a degree in Medicine (attending physicians: ≧6 years, senior residents: 3–5 years, junior residents: ≦2 years). The attending physicians and senior residents were internist. Junior residents did not have any specialization and rotated through several departments at the hospital. Participants who refused to participate in this study or had hearing loss were excluded. The research was conducted in accordance with the Declaration of Helsinki. The study was approved by the institutional review board of Dokkyo Medical University Hospital, Tochigi, Japan (R-49-18J). Written informed consent was obtained from each participant after the explanation of this study's protocols before participation.

Hirosawa T., Ito T., Harada Y., Ikenoya K., Yokose M, & Shimizu T. (2023). The utility of phonocardiograms in real-time remote cardiac auscultation using an internet-connected electronic stethoscope: Open-label randomized controlled pilot trial. Digital Health, 9, 20552076231161945.

Publication 2023

Auscultation Cardiovascular System Diagnosis Ethics Committees, Research General Practitioners Hearing Impairment Heart Auscultation Patients Pharmaceutical Preparations Physicians

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What are the different techniques and methods used in auscultation?

Auscultation can be performed using a variety of techniques and methods. The most common approach is the use of a stethoscope, which allows healthcare providers to listen to internal bodily sounds such as heart beats, breath sounds, and bowel sounds. However, there are also other auscultation methods, including the use of electronic stethoscopes, phonocardiography, and lung sound analysis software. Each technique has its own advantages and can be selected based on the specific clinical needs and the provider's expertise.

How can PubCompare.ai help optimize auscultation research?

PubCompare.ai is a powerful tool that can assist researchers in optimizing their auscultation studies. The platform allows you to efficiently screen protocol literature, leveraging advanced AI-driven analysis to pinpoint critical insights. By utilizing PubCompare.ai, researchers can identify the most effective auscultation protocols for their specific research goals, helping to enhance the reproducibility and accuracy of their findings. The platform's AI-driven comparisons can highlight key differences in protocol effectiveness, enabling researchers to choose the best option for their studies.

What are some common challenges in performing accurate auscultation?

Auscultation requires extensive training and experience to accurately interpret the sounds detected. Some common challenges include: 1. Ambient noise: External sounds, such as those from machines or other sources, can interfere with the ability to hear and interpret internal bodily sounds. 2. Patient positioning: The patient's positioniing and clothing can affect the quality of the sounds heard during auscultation. 3. Interpreter variation: Different healthcare providers may interpret the same auscultatory findings differently, leading to inconsistencies in diagnosis and treatment. 4. Reproducibility: Ensuring consistent and reproducible auscultation findings can be challenging, especially when comparing across different providers or studies.

How does auscultation contribute to accurate medical diagnosis?

Auscultation is a critical skill in medical practice, as it allows healthcare providers to assess cardiovascular, respiratory, and other physiological functions. By listening to internal bodily sounds, providers can detect abnormalities that may indicate underlying health conditions. Proper technique and interpretation of auscultatory findings are essential for accurate diagnosis and effective treatment. For example, the detection of heart murmurs or abnormal breath sounds can lead to further investigations and the identification of cardiovascular or pulmonary disorders. Auscultation, when combined with other clinical assessments, helps healthcare providers make more informed decisions and provide better patient care.

What are some of the latest advancements in auscultation technology?

The field of auscultation is constantly evolving, with ongoing research and development of new technologies to enhance the reproducibility and accuracy of this critical medical skill. Some of the latest advancements include: 1. Electronic stethoscopes: These devices incorporate digital sensors and signal processing algorithms to amplify and analyze internal bodily sounds, providing more detailed and objective data for interpretation. 2. Lung sound analysis software: Specialized software can digitize and analyze lung sounds, helping to identify patterns and abnormalities that may be difficult for the human ear to detect. 3. Artificial intelligence (AI) and machine learning: AI-powered algorithms are being developed to assist healthcare providers in the interpretation of auscultatory findings, potentially improving diagnostic accuracy and consistency. These technological advancements, coupled with PubCompare.ai's ability to help researchers identify the most effective auscultation protocols, are driving the field of auscultation forward and enhancing patient care.

More about "Auscultation"

Auscultation, a critical medical skill, involves the act of listening to internal bodily sounds, typically using a stethoscope.
This non-invasive technique allows healthcare providers to assess cardiovascular, respiratory, and other physiological functions by detecting and interpreting various sounds, such as heart beats, murmurs, breath sounds, and bowel sounds.
Proper auscultation technique and interpretation of findings are essential for accurate diagnosis and effective treatment.
Extensive training and experience are required to accurately identify abnormal findings that may indicate underlying health conditions.
Research into auscultation methods and devices, including the Finometer, Polar RS800cx HR monitor, TBF-310 GS Body Composition Analyzer, HP Patient Monitor, Littmann Cardiology III, Littmann 3200, and HBP-9020, is ongoing to enhance reproducibility and accuracy in clinical practice.
Anesthetic agents like Isoflurane and fluids like Lactated Ringer's solution may also be relevant in certain auscultation procedures.
Auscultation is a vital skill in medical practice, allowing healthcare providers to assess physiological functions and make informed diagnoses.
Optimizing auscultation research through tools like PubCompare.ai can help improve the reproducibility and accuracy of this critical technique.