ABSTRACT
This study evaluated an open access general practitioner radiological service. Questionnaires were completed in 216 out of 250 cases both before and after radiological examination. Chests and specials (bariums, intravenous urography, ultrasound) were most often of diagnostic value when confirming normality, while other radiographs were more likely to be of value in assessing the severity of known disease (P less than 0.001). Patient therapy was altered in 31% of cases following receipt of the radiological report, and management was changed in 40%. In 25% of cases the patient was discharged on receipt of the report. In 28% of cases the report avoided a hospital referral. Special examinations were most likely (P less than 0.05) to avoid a referral. It is concluded that open access radiology is a considerable help with diagnosis and management, and substantially reduces out-patient referrals. The possible consequences for the acute services of providing a full general practitioner diagnostic service are discussed.
Subject(s)
Family Practice , Health Services Accessibility , Hospital Departments/statistics & numerical data , Radiology Department, Hospital/statistics & numerical data , England , Evaluation Studies as Topic , Humans , Radiology Department, Hospital/economics , Referral and Consultation , Statistics as Topic , Surveys and QuestionnairesABSTRACT
This trial aimed to test if the half life of radioiodinated heptadecanoic acid (HDA) in acutely infarcted myocardium is of prognostic value. Twenty patients had an HDA scan and a MUGA scan within 6 days of acute myocardial infarction, eighteen of these had a visible defect on the HDA images. The mean half life of the areas of acute infarction (15.50 min +/- 7.82 min) was significantly shorter than that of normal myocardium (20.77 min +/- 4.00 min). The MUGA scan was repeated after 6 months in 15 patients. The mean acute infarct half life was longer in patients with an LVEF improvement of at least 5% at 6 months (16.92 min +/- 10.56 min), compared to those with a deterioration of more than 5% (11.75 min +/- 4.03 min), although the difference is not statistically significant. While the results in a few individuals suggested that the half life may be of prognostic significance, the variable response of the group reduced the ability of the half life to act as a prognostic indicator. Improvements in imaging and background subtraction techniques may be necessary before the half life is of practical value.
Subject(s)
Fatty Acids , Iodine Radioisotopes , Myocardial Infarction/diagnostic imaging , Clinical Trials as Topic , Fatty Acids/metabolism , Half-Life , Humans , Prognosis , Radionuclide ImagingABSTRACT
Ten patients underwent myocardial scintigraphy with 123I-iodo-heptadecanoic acid (HDA), which was injected in the last minute of maximal exercise testing. Six of the patients were rescanned following percutaneous transluminal coronary angioplasty. All ten patients underwent full coronary angiography. There were visible perfusion defects on the static images in 74% of the myocardial areas which were supplied by an artery with a stenosis greater than 75%. The mean half life recorded from areas distal to an arterial stenosis of at least 90% (35.69 min +/- 41.25 min), was longer than the expected normal mean (18.85 min +/- 3.35 min). However, the difference was not statistically significant. The static images changed in some patients following angioplasty, however there was no consistent alteration in the half lives. It was concluded that HDA is a suitable agent for investigating myocardial perfusion, but that the half life cannot be measured adequately for clinical purposes with a planar imaging system.
Subject(s)
Angioplasty, Balloon , Coronary Disease/diagnostic imaging , Coronary Vessels/diagnostic imaging , Fatty Acids , Heart/diagnostic imaging , Iodine Radioisotopes , Coronary Disease/therapy , Humans , Radionuclide ImagingABSTRACT
The mucosal coating properties, liability to bubble formation and palatability of a new barium sulphate suspension (Micropaque HD) were compared with those of the barium suspension shown by previous trials to produce the best results (E-Z-HD). The results show that E-Z-HD gave significantly better mucosal coating and was less liable to bubble formation. There was no significant difference in the palatability of the two preparations.
Subject(s)
Barium Sulfate , Digestive System/diagnostic imaging , Contrast Media , Humans , RadiographySubject(s)
Bone and Bones/diagnostic imaging , Collagen Diseases/diagnostic imaging , Osteomalacia/diagnostic imaging , Adolescent , Adult , Aged , Biopsy , Bone and Bones/pathology , Child , Collagen Diseases/complications , Collagen Diseases/pathology , Female , Humans , Male , Middle Aged , Osteomalacia/etiology , Osteomalacia/pathology , RadiographyABSTRACT
Five hundred barium enemas were reviewed to find the influence of the decubitus films on the radiologist's report. In two cases they demonstrated abnormalities that had not been seen on any other film. In 21 out of 43 cases they resolved a diagnostic problem that had arisen when viewing the other films. They were of greatest value in differentiating possible polyps from faecal residue in patients with imperfect bowel preparation.