Radiology

Article Abstract:

During the past year there have been some exciting clinical and research developments in diagnostic radiology. Different approaches will be tested in the treatment of atherosclerotic vascular disease (in which the linings of arteries become covered with plaque) using animal models (swine) whose vessels are similar in size to human blood vessels. Angioplasty (insertion and inflation of a small balloon in a damaged vessel) is being tested as a treatment for intracranial vasospasm (abnormal contraction of a vessel within the skull). Vasospasm can occur after subarachnoid hemorrhage (bleeding under the arachnoid, one of the membranes covering the brain) and result in devastating consequences. Better images of the blood vessels in the brain are being obtained with magnetic resonance angiography (MRA), but there are some limitations on the types of problems for which MRA is suitable. Nuclear radiology (the use of a scanner to trace radioactive substances which pass through the brain) has benefitted from the development of new chemicals, which enter the brain more easily and document loss of brain function more accurately. These methods also have potential for distinguishing between the causes of dementia (loss of cognition), such as Alzheimer's disease and multi-infarct dementia (dementia following a cerebrovascular accident or stroke). Monoclonal antibodies (molecules attached to toxic substances, which 'home' to specific molecular targets, such as cancer cells, and kill them) have not yet found widespread use in nuclear oncology (cancer treatment), but their use in treating some cardiovascular disorders is promising. Overall, the field of diagnostic radiology is on the brink of a most exciting future. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Reports, Magnetic resonance imaging, Monoclonal antibodies, Atherosclerosis, Angioplasty, Radioactive tracers

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Teleradiology for a family practice center

Article Abstract:

Teleradiology involves transmitting roentgenograms (X-ray photographic records of internal structures of the body) over standard telephone lines via a modem from one site to another. It has been used for almost 30 years as a method of diagnostic consultation to avoid delays in diagnoses. In this study, a combination of X- rays of the chest and extremities produced at a family practice center were transmitted to a nearby university hospital for consultation. A radiologist at the university hospital examined the X-ray reproductions and telephoned a report, through an intermediary, back to the family practice center. Family physicians changed their diagnoses only 3.5 percent of the time, based on teleradiology consultation reports. However, teleradiology consultation affected the confidence level of family physicians regarding their own diagnosis in 51 percent of the cases; they became either less or more certain of their own diagnosis based on the teleradiology report. The pros and cons of using teleradiology images are weighed. The quality of teleradiology has improved over the years, and the consultation method is still considered to be valuable. It is to be noted that the degradations in teleradiological images reduce diagnostic accuracy when fine resolution is necessary, and that patient convenience is affected in 25 percent of cases.

Analysis, Innovations, Services, Family medicine, X-rays, Facsimile transmission, column

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The 'house call' in the electronic era

Article Abstract:

Patients who receive medical care over the telephone may receive better treatment than those who are only treated at office visits. A study of older male veterans who received medical care over the telephone found that telephone visits were as effective as face-to-face visits for monitoring some types of medical conditions. Advantages of telephone care include less work for medical office staff and physician, increased patient satisfaction from increased physician-patient communication, and better access to medical information. A study of cancer patients who received psychotherapy over the telephone found that they were less anxious, and had more access to their physician. The disadvantages of telephone consultations include the disruption of unscheduled calls, the lack of body language and other nonverbal diagnostic clues, the absence of physician-patient physical contact, and poor telephone communication skills. Patient care over the telephone may increase in the future with the development of new communication technologies.

Editorial, Medicine, Telecommunications systems, Telephone, Telephony, Patient monitoring, Physiologic monitoring

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