The history of physical diagnosis started with Hippocrates and his school. History taking, inspection, palpation, and sometimes immediate auscultation and examination of the urine are fundamental diagnostic tools. The Hippocratic Corpus and Galen’s authoritative theoretical writings dominate medical thinking for over 1000 years. Clinical examination advances through Vesalius and Morgagni’s discoveries of human dissection (1543) and pathologic anatomy (1761) respectively. The Vienna school through Auenbrugger introduces percussion in 1760. The Paris school formally establishes physical diagnosis with the invention of the stethoscope by Laennec in 1816.
Medical History Taking ; Percussion

BACKGROUND AND OBJECTIVES: Patients with benign paroxysmal positional vertigo (BPPV) usually have typical history. They usually complain of vertigo that lasting a few seconds to a minute. It usually occurs in the morning after awaking and provoked by typical positional change such as head turning, sitting, and lying down. However, some patients may describe their vertigo in a rather atypical way, so there is no absolute reliability of a diagnosis based on history taking. To evaluate the reliability of a diagnosis based on history taking, we performed prospective studies. MATERIALS AND METHODS: We obtained structured history from all the patients with BPPV. Total of 408 patients were diagnosed as having BPPV. The diagnosis was based on typical findings of vertigo and nystagmus by Dix-Hallpike maneuver and head turning in supine position. RESULTS: Duration of vertigo was more than 10 minutes in 22% of patients. Position-precipitating factors were not spontaneously reported by 37%. 16% of patients complained non-spinning vertigo. 38% of patients could not tell the side to which the spell occurs. In 83 cases (20%), it was impossible to diagnose BPPV based upon a typical history. CONCLUSION: We conclude that non-paroxysmal, non-positional vertigo dose not rule out BPPV. The provocation test is mandatory in those complaining of dizziness regardless of history since BPPV can be quickly diagnosed by provocation test and easily treated.
Deception ; Diagnosis* ; Dizziness ; Head ; Humans ; Medical History Taking ; Prospective Studies ; Supine Position ; Vertigo*

There has been continuous effort to prevent transfusion-transmitted infection (TTI). Strategies to prevent TTI can be divided into two components: first, determining donor eligibility, and second, managing bacterial contamination of blood products. To determine donor eligibility, medical history taking and screening tests for infectious diseases should be performed. To prevent bacterial contamination, blood collection process should be aseptic, tests for bacterial detection should be performed, and an application of pathogen reduction technology should also be considered. In this review, screening test items and methods, including nucleic acid amplification tests for determining donor eligibility, and precautions for blood collection, bacterial detection methods, and pathogen reduction technology for the prevention of bacterial contamination of blood products were discussed in detail.
Communicable Diseases ; Donor Selection ; Humans ; Mass Screening ; Medical History Taking ; Nucleic Acid Amplification Techniques ; Tissue Donors

PURPOSE: To evaluate and analyze the clinical characteristics and history of patients with hemoperitoneum due to ovarian rupture. METHODS: Subjects were fertile females who visited the emergency department between January 2006 and December 2008. We did retrospective chart reviews only for patients diagnosed with hemoperitoneum. We investigated the characteristics and history of enrolled patients. RESULTS: A total of 76 females (mean age = 28 years) were enrolled. Of the 76, 32 (41.8%) were initially checked for coitus history by emergency physicians (EP). Of the 76, 52 (68.4%) were operated on and the remaining 24 (31.6%) were only observed. Only 4 patients had knowledge of a history of ovarian cysts. CONCLUSION: Coitus history and ovarian cyst history should be done by EPs during the initial examination of fertile females who complain of lower abdominal pain.
Abdominal Pain ; Coitus ; Emergencies ; Female ; Hemoperitoneum ; Humans ; Medical History Taking ; Ovarian Cysts ; Retrospective Studies ; Rupture

Abdominal pain is a common chief complaint that brings patients to emergency departments and outpatient offices. The causes of abdominal pain are numerous, ranging from life-threatening to self-limiting disorders. Diagnostic approaches are often difficult because of the nonspecific and overlapping nature of pain, regardless of the underlying cause. A careful medical history taking is the initial diagnostic step. All patients should undergo systematic examinations, regardless of the differential diagnosis suggested by the history. On the basis of the clinical suspicion and laboratory investigations, the physician will consider imaging examinations to help establish the correct diagnosis. Various endoscopic and imaging modalities have important roles in diagnosing many causes of abdominal pain. Diagnostic approaches rely on the likelihood of disease obtaining from histories of patients, physical examinations, laboratory tests, and imaging studies. Furthermore, the evaluation of abdominal pain must be efficient and lead to an accurate diagnosis early in the presentation. It is also important to consider special populations such as women especially during pregnancy and the elderly, because of presentations may differ and are often complicated by coexistent disease.
Abdominal Pain ; Aged ; Diagnosis, Differential ; Emergencies ; Female ; Humans ; Medical History Taking ; Outpatients ; Physical Examination ; Pregnancy

PURPOSE: The developmental history is an important element in the evaluation of children with epilepsy. However, obtaining accurate information from history is often very difficult especially in older children because of their parents' incomplete recollection. This study was aimed to investigate if the timing of independent walking has a valuable clinical significance in children with epilepsy. METHODS: We classified 262 patients with epilepsy into normal and delayed groups from a history of the timing of independent walking at 18 months as a cutoff point. We compared their clinical and laboratory characteristics between two groups. RESULTS: Out of 262 patients, twenty one (8%) were delayed. There was no difference in seizure types between two groups. The Age of seizure onset and diagnosis of epilepsy was earlier in delayed group (5.6:2.2 years, P<0.001; 7.0:3.2 years, P<0.001). The proportion of Cesarean section and preterm delivery were also higher in delayed group (25%:52%, P= 0.010; 6%:29%, P<0.001). Abnormal MRI findings were more frequent in the delayed group (19%:86%, P<0.001). EEG at diagnosis showed no difference in epileptiform discharges, but background abnormality was more common in the delayed group (15%:81%, P<0.001). EEG at 1 year after the diagnosis showed both epileptiform discharges and background abnormality were more frequent in the delayed group (60%:90%, P=0.004; 14%:67%, P<0.001). CONCLUSION: Based on the result of this study, we strongly recommended that we should take a history of the timing of independent walking in children and adolescents with epilepsy.
Adolescent ; Cesarean Section ; Child ; Electroencephalography ; Epilepsy ; Female ; Humans ; Medical History Taking ; Pregnancy ; Seizures ; Walking

PURPOSE: Nonverbal communication (NVC) may be a crucial factor affecting effective communication between patients and medical students during the objective structured clinical examination (OSCE), but it has not been intensively studied. We examined NVC and its correlation with patient-physician interaction (PPI) in the OSCE. METHODS: A total of 68 video recordings of routine check-up OSCEs were included. A checklist for NVC was developed that included seven nonverbal factors in a mute state (NVM) and four nonverbal factors in speech (NVS), and one point was assigned to each factor. The scores for history taking, PPI, NVM, and NVS were compared, and correlations of each score were evaluated. RESULTS: Students with adequate facial expressions, accorded speech rate and voice volume, adequately matched voice tone, and few or no moments of unnecessary silence showed better PPI scores. The PPI score was correlated with history taking and the NVS score, but not the NVM score. CONCLUSION: Our results suggest that NVS may be more influential to PPI during OSCEs than NVM. Communication teachers should help students to be better prepared to use both NVS and NVM properly.
Checklist ; Education, Medical ; Facial Expression ; Humans ; Medical History Taking ; Nonverbal Communication* ; Patient Satisfaction ; Students, Medical* ; Video Recording ; Voice

The clinical approach to the evaluation of suspected physical abuse in children is briefly reviewed in this article. Child physical abuse refers to the infliction of injury on any part of a child's body. In 2006, 5,202 children were confirmed to be victims of child abuse in Korea. Among them 35% were classified as physical abuse. The physical abuse has usually been underreported because most injuries of childhood are not the result of abuse and an injury pattern is rarely pathognomonic for abuse or accident without careful consideration of the explanation provided. The medical assessment is outlined with respect to obtaining a history, physical examination, clinical manifestation, and appropriate ancillary testing. Detection of physical abuse is dependent on the doctor's ability to recognize suspicious injuries, such as bruising, bite marks, burns, and bone fractures. The physician should be able to recognize suspicious injuries, conduct a comprehensive and careful examination with appropriate auxiliary tests, critically assess the explanation provided for the injury, and establish the probability that the explanation does or does not correlate with the pattern, severity, and age of the injury. Suspected cases of child abuse should also be well documented and reported to the appropriate public agency which should assess the situation and help to protect the child.
Bites and Stings ; Burns ; Child ; Child Abuse ; Diagnostic Tests, Routine ; Fractures, Bone ; Humans ; Korea ; Medical History Taking ; Physical Examination

BACKGROUND: Semiology of epileptic seizure is very important for diagnosis and treatment. However, little is known about the reliability of the observers' description. This study aims to determine the description reliability of seizures in the aspects of classification and lateralization. METHODS: We recorded 72 patients with habitual seizures during video-EEG monitorings. We, then, compared the ictal behaviors described by frequency observers and those recorded on the videotape to compare the accuracy of the observers' descriptions. Finally, we reviewed which aspects of the informants affected the reliability of the data. RESULTS: The classification of seizures based only on the observer-description was somewhat discordant from the videotape (correct classification: 82%) especially in dividing simple partial from complex partial seizures. Description of many ictal behaviors in presumed complex partial seizure such as oroalimentary automatism, motionless staring, tonic/clonic posture and version was accurate except for the hand automatism. A specified direction by the observer has a very high true positive rate. The accuracy of the description was related to the educational status of the observer. CONCLUSIONS: Semiology description by well-educated observers is may be reliable, but every physician should keep its limitation in mind and judge accordingly.
Automatism ; Classification ; Diagnosis ; Educational Status ; Epilepsy ; Hand ; Humans ; Medical History Taking ; Posture ; Reproducibility of Results ; Seizures ; Videotape Recording

This study aimed to determine the effect of the SNAPPS (summarize, narrow, analyze, probe, plan, and select) method versus teacher-centered education on the clinical skills of midwifery students in Iran. In this clinical trial, 36 midwifery students in their 4th year of education in 2015 were enrolled and divided into 6 groups, 3 groups for teacher-centered education and 3 groups for the SNAPPS method, with each group spending 10 days in the outpatient gynecology clinic. A questionnaire and a checklist were used to gather data. An independent t-test and chi-square test were used to analyze the data. Ability to gain the trust of the patient, verbal and nonverbal communication skills, history taking, preparation of the patient for gynecological examination, and diagnosis and treatment of common diseases were significantly better in the SNAPPS group compared to the teacher-centered education group (P<0.05). The SNAPPS education method can significantly improve the clinical skills of midwifery students in gynecology, in particular history taking, differential diagnosis, and treatment of common diseases.
Checklist ; Clinical Competence ; Diagnosis ; Diagnosis, Differential ; Education* ; Gynecological Examination ; Gynecology* ; Humans ; Iran* ; Medical History Taking ; Methods* ; Midwifery* ; Nonverbal Communication ; Outpatients