Introduction: While there are several studies on reliability of telemedicine in assessing stroke scales, little is known about the validity of a general neurological examination performed via telemedicine. Therefore, we sought to test the agreement between bedside and remote examination in acute patients of the emergency room. Methods: Acute patients at the emergency room of a 450-bed academic teaching hospital were included in this study. A clinical neurological examination consisting of 22 items was performed at bedside and also remotely via an audio-visual link by a different neurologist; both were experienced clinicians at the consultant level. Kappa statistics were calculated for each item of the examination. Results: Forty three patients completed both examinations (mean age 58.3 years, 56% female). Patients were seen between 8 and 72 min after admission (mean 36.3 min). Total time for remote examination was 12.6 min (8–21 min) and 8.9 min (5–18 min) for bedside examination. K-coefficients ranged from 0.32 (muscle tone) – 0.82 (language) indicating a fair to excellent agreement in most items. Conclusions: Remote examination via an audio-visual link produces comparable results to bedside performance even in acute patients of the emergency room. Compared to the scarce data available, inter-observer agreement is about the same as that between 2 examiners at bedside. However, more studies on reliability and validity of clinical neurological examination are required.
[Purpose] To introduce a new systematic physical therapy evaluation aiming to facilitate
the process of examining complicated musculoskeletal cases. [Subject and Methods] The
patient was a 20 years old male college student who had major motor vehicle accident one
year ago. The patient was poorly responding to physical therapy and he felt that his case
was worsening. The complexity of the case dictated a new evaluation with a different
approach to resolve the barriers hindering the patient from showing functional
improvements. [Results] The new evaluation approach explained many undetermined and
stubborn symptoms experienced by the patient. The expert confirmed that the traditional
evaluations methods utilized were insufficient to address patient’s complaints.
[Conclusion] Total Assessment-Reassessment & Evaluation using bioKinesiologic (TAREK)
approach is comprehensive evaluation strategy using systematic pathway that guides
clinicians to pinpoint the contribution of pathoanatomical structures in producing
pathomechanical mobility and poor functional outcomes.
Background
Coronavirus disease 2019 (COVID-19) is a newly emerging pandemic that affected millions of people worldwide caused by novel coronavirus SARS-CoV-2. The first cases reported suffered from respiratory symptoms.
Main body
Various extrapulmonary manifestations were linked to COVID-19 in several reports including cardiovascular, genitourinary, gastrointestinal, and skin. It is important that every clinician should be aware of these non-respiratory manifestations for early diagnosis and prompt management. This review aims to summarize the different extrapulmonary manifestations of COVID-19 disease and highlight the importance of multidisciplinary care.
Conclusion
COVID-19 is a disease of multi-organ involvement. Manifestations may vary depending on which organ is involved.
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