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Biomedical subjects

M Gaskill

Publications and source records attributed to M Gaskill.

22 records · Page 2Linked to original sources
PubMed1987

The value of hepatobiliary scans in fasted patients receiving total parenteral nutrition.

Hepatobiliary scanning is considered to be a highly accurate method for the diagnosis of acute cholecystitis. False-positive scans (failure to visualize the gallbladder in the absence of cholecystitis) have been reported to occur in fasted patients receiving total parenteral nutrition (TPN). To determine the prevalence of false-positive scans in this patient population and identify factors that might be associated with scan outcome, hepatobiliary imaging was performed in fasted patients receiving TPN and without clinical evidence of acute cholecystitis. Gallbladder nonvisualization occurred in 18 of 50 (36%) patients. In the group whose gallbladders did not visualize, a significantly higher male to female ratio (15:3 versus 17:15; p = 0.016), alkaline phosphatase (346 +/- 84 IU/L versus 212 +/- 32 IU/L, p less than 0.04), total bilirubin (1.7 +/- 0.3 mg/dl versus 1.0 +/- 0.2 mg/dl, p less than 0.02), and lower serum albumin (2.4 +/- 0.01 gm/dl versus 2.8 +/- 0.2 gm/dl, p less than 0.02) levels were noted. In 18 patients, gallbladder ultrasonography was also performed, and the presence of sludge or a thickened gallbladder wall did not correlate with scan outcome. The prevalence of false-positive hepatobiliary scans in fasted patients receiving TPN is significant and does not always correlate with a syndrome of acute gallbladder inflammation. The results of such scans must therefore be interpreted with caution in these patients.

Adult↗
PubMedDate not supplied

Medicaid. Can it meet the needs of Texas' indigents?

Whether doctor or patient, Democrat or Republican, regulatory official or hospital administrator, there is one thing almost everyone agrees on: some changes to the Medicaid system are in order. Established in 1965, Medicaid was created to provide medical care to the poor in this country, to underwrite the care of the poor, the disabled, low-income elderly, blind and those otherwise disenfranchised from the mainstream of modern health care. As with any new understanding, there was little certainty about how many people Medicaid would serve, how it would work or how much it would cost. Egregious errors were made in the structure and process, and attempts to correct them have not been effective. Texas Hospitals asked a cross-section of people and institutions, "What would you change about Medicaid?" A variety of different ideas were put forth; some obviously self-serving answers emerged. But no one asked failed to have an answer to the question. We all agree; Medicaid needs some changes.

Aid to Families with Dependent Children↗