Biomedical subjects
Publications and source records attributed to S Halpern.
The way regions throughout the United Kingdom cope with the confusion surrounding cuts in the health service is described by Stephen Halpern. In the first of three articles he gives a guide to the financial state of play in the Thames regions and, to bring in a breath of country air after the foggy and depressing financial climate of London, Oxford RHA.
In one of its more decisive moments the Royal Commission recommended the abolition of FPCs and the assumption of their functions by health authorities. In this article, author looks at the debate surrounding this issue and in particular GPs' problems in inner city areas. He says that while more could be achieved by making the management expertise of the hospital sector available in the primary sector, wards will always be easier to control than GPs' surgeries.
Whither the HAS? Did Normansfield point up its ineffectiveness, as it critics allege? A personable enough body in its way, they say, but somewhat toothless. The Royal Commission saw it differently, approving of its service 'by persuasion rather than coercion'. What are the alternatives to this maligned body?
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Supplies officers do not seem to have much luck with government working parties and their status has declined since 1968. Today they are very much second line management. To help rehabilitate the discipline he calls for recognition from other groups that supplies officers have a professional function to perform.
The rapid explosion of functionalism in the NHS since reorganisation has left not a few administrators frustrated with their decreased authority and many functional officers concerned at the status and structure of their professions. Over the next three weeks the Journal will be taking six of the major health service functions and examining the importance to patient care of their roles and the difficulties of integrating senior functional management into the administrative hierarchy. Author describes the trials and tribulations of being a works officer.
The intention of making RAWP a blanket, consistent formula has created a system too inflexible to reflect the oblique demand on services in areas of social deprivation and decline.
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A patient with thyroid cancer is described whose metastases were detected only after the administration of a large therapeutic dose of 131 Iodine. This suggests that very high doses of 131 Iodine might permit diagnoses of metastatic lesions not otherwise detected. This phenomenon may be explained by the improved counting statistics which occur with the use of a higher dose of the isotope. In such cases, exceedingly high doses of 131 Iodine might be necessary for successful tumor ablation.
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99mTechnetium penicillamine, a renal cortical imaging agent, can be used to provide a rapid, safe and non-invasive assessment of renal morphology and the renal vascular supply. Since this agent is not excreted significantly during the imaging procedure cortical scans of high quality can be obtained without image deterioration owing to a superimposed collecting system. These scans, which are clearly superior in anatomical detail to earlier scans using 131I hippuran, can be obtained along with the 131I hippuran renogram when the patient comes to the nuclear medicine department. Herein we demonstrate the anatomical detail it is now possible to achieve by presenting the cortical renal scans and accompanying radiograms from 5 patients with different renal pathology.
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Even though the radiocolloid scan is nonspecific it will be approximately 70%-80% accurate in predicting the presence or absence of liver disease and somewhat less accurate than that in making statements as to the specific type of disease. This compares well with other modalities. The ability of nuclear medicine techniques to provide a correct diagnosis is improved when additional isotopic techniques such as hepatic blood flow studies and 131I-rose bengal and 67Ga scanning are performed. Ultrasound scanning is also non specific. To date, the major application of ultrasound in the study of the liver has been in deciphering puzzling contour abnormalities seen on nuclear medicine scans and in demonstrating fluid-filled abnormalities. Its usefulness in diffuse and solid focal lesions has been less dramatic. More recently, however, the development of gray scale has necessitated a reevaluation of the technique. Gray scale demonstrates a large number of intrahepatic interfaces that were previously invisible, and it has already been shown to demonstrate focal disorders such as metastasis more easily than the nongray-scale method. It can also demonstrate dilated biliary radicals, the gallbladder, and gallstones. In addition, while routinely studying the liver one can evaluate diaphragmatic motion and various retroperitoneal structures such as the pancreas, lymph nodes, and abdominal vascular structures.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.