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Biomedical subjects

R Belsey

Publications and source records attributed to R Belsey.

At least 37 records · Page 2Linked to original sources
PubMed1987

Aluminemic disturbance of technetium-99m DTPA renal function measurement.

During follow-up study of a patient with surgically corrected unilateral renal ischemia, using computer image generated [99mTc]diethylenethiaminepentaacetic acid (DTPA) glomerular filtration rate (GFR) and [131I]orthoiodohippurate estimated renal plasma flow (ERPF), we observed prominent gastric and intestinal uptake of 99mTc. Profound alteration in the GFR results, but not the ERPF results, was also observed. Radiopharmaceutical breakdown was suspected and shown to be endogenous and due to hyperaluminemia at 28 ng/ml. These case findings add DTPA to the list of 99mTc radiopharmaceuticals that have previously been reported to have altered biodistribution when hyperaluminemia is present. The case findings also reaffirm the benefits of obtaining images to corroborate the validity of quantitative data and demonstrate that quantitative radionuclide renal function data are not independent of renal chemical handling.

Aluminum↗
PubMed1986

Managing liability risk in the office laboratory.

New technology has created new responsibilities and new risks for office practitioners who develop and use an office laboratory. Mistakes are bound to occur, but a system organized along the lines suggested is a workable way to minimize the number of mistakes and lessen the consequences of any mistakes that do occur. If a significant problem occurs and these guidelines have been ignored, it is likely they will be used as a framework for inquiry. The benefit to the physician and patient far outweighs the risk of using the new technology and procedures. Any risk is manageable because the physician has the opportunity to control the technology selected, the procedures and protocols used, and the persons involved in the testing process.

Financial Management↗
PubMed1986

Laboratory test analysis near the patient. Opportunities for improved clinical diagnosis and management.

New developments in laboratory technology have produced complex analytic systems that are simple to operate, relatively reliable, and inexpensive. These systems allow the office practitioner to perform test analyses in an office laboratory and can provide timely information useful for diagnostic and clinical management decisions. This article reviews the clinical applications and analytic systems available for use in urine analysis, blood cell analysis, determination of the sedimentation rate, coagulation testing, biochemical analysis, and bacteriologic and virologic testing. Although these analytic systems are generally designed to be used by nonprofessional laboratory staff, there is only limited information available about their reliability when used in this manner. Physicians, in bringing this technology into their office laboratories, must be cognizant of a new area of medical practice because they will now be the professionals responsible for the laboratory's function. It will be important that they develop new skills as the office laboratory directors and develop consultative relationships with laboratory professionals to ensure that the information used in patient care is both timely and reliable.

Bacteriological Techniques↗
PubMed1986

Regulation of physicians' office laboratories. The Idaho experience.

Timely availability of reliable test results enhances the office practitioner's ability to provide high-quality care that is personally satisfying to patients. Modern technology allows physicians to have such timely information available through test analyses performed in an office laboratory. Studies of physicians' office laboratories in Idaho found the performance, initially, to be unacceptably variable for many hematology, urinalysis, clinical chemistry, and microbiology tests. State regulation, requiring each office laboratory to comply with quality assurance guidelines and to participate in a proficiency testing program, resulted in a marked improvement in the proficiency level of office laboratory testing in Idaho. With the increasing dispersion of clinical laboratory technology, it is essential that standards of practice for the office laboratory be developed that ensure, within reasonable limits, the reliability of test information used in patient care. If widespread acceptance of such standards cannot be developed with a voluntary approach, states should consider regulation of office laboratories within their jurisdiction. Compliance with standards of practice, voluntarily or as a result of regulation, should promote quality performance in the office laboratory and allow the physician to use confidently the timely test information in dealing with diagnostic and management problems in patient care.

Facility Regulation and Control↗
PubMed1986

Proficiency of office microbiology testing.

Microbiology proficiency testing results from smaller physicians' office laboratories in the state of Pennsylvania are reviewed. Possible reasons for lower performance levels are discussed, and some approaches to improving microbiology proficiency in this setting are suggested.

Ambulatory Care↗
PubMed1984

Controlling the use of stat testing.

Overused stat testing consumes an excessive share of the laboratory budget in many health care settings. The clinical practitioners and laboratory personnel in the setting described in this article negotiated a multifaceted program that resulted in a 95 percent reduction in the use of stat testing and improved the turnaround time of stat results for patients with potentially emergent problems. Financial savings from the program allowed a no-growth laboratory budget for the following fiscal year.

Clinical Laboratory Techniques↗
PubMed1977

Oesophageal trauma: incidence, diagnosis, and management.

The clinical manifestations, diagnosis, and surgical treatment of 110 cases of oesophageal trauma, admitted under the care of one surgical team between 1949 and 1973, are reviewed. The importance of early diagnosis and an aggressive surgical approach in the management of a potentially lethal situation are stressed. In our opinion, spontaneous rupture of the oesophagus, instrumental perforation, open and closed traumatic lesions, and postoperative anastomotic leaks are, as far as diagnosis and management are concerned, different aspects of the same desperate surgical problem. Oesophageal trauma is accompanied by a high morbidity and mortality rate if diagnosis and treatment are delayed. Perforations of the cervical oesophagus may be treated conservatively. Intrathoracic perforations demand an aggressive surgical appraoch; only exteriorisation followed by reconstruction at a later date offers a reasonable chance to save the life of the patient and ultimately restore continuity.

Adult↗
PubMed1977

[Gastroesophageal reflux and chronic or acute broncho-pulmonary diseases in adults].

Forty four observations of patients with chronic or acute broncho-pulmonary affections were gathered over 6 years. All exploration tests for an obstructive etiology were negative. All these patients had a hiatal hernia by sliding with gastro-oesophageal reflux. In 27 patients the repeated pulmonary accidents, the importance of oesophageal symptomatology prompted a treatment of the hiatal hernia. In all these patients every pulmonary symptoms disappeared. In assessing some acute or chronic pulmonary affections, when etiology cannot by traced, besides considering anatomical, clinical and histological data, radiological and endoscopic examination should be undertaken to find gastro-oesophageal reflux.

Acute Disease↗