PubMed Health⌕ Search

Biomedical subjects

F H Miller

Publications and source records attributed to F H Miller.

At least 19 recordsLinked to original sources
PubMed1996

Pancreaticobiliary manifestations of AIDS.

The pancreas and the biliary tract are frequent sites of infectious, Inflammatory, and neoplastic disease in patients with HIV infection. However, the symptoms of pancreaticobiliary involvement may be relatively mild so that the prevalence of these disorders is probably underestimated. An appreciation of the imaging findings of HIV-associated pancreaticobiliary disorders is important because involvement of these organs may be the only criterion that establishes the diagnosis of AIDS (Table 1).

AIDS-Related Opportunistic Infections↗
PubMed1996

The legal ramifications of the NCCN practice guidelines.

Physicians concerned about being sued for medical malpractice for following (or deviating from) a clinical practice guideline written by the National Comprehensive Cancer Network (NCCN) or otherreputable group should keep in mind one general principle: "Good medicine is good law." In other words, if a physician follows a course of action in line with the professional standard of care, regardless of whether or not he or she adheres to a particular guideline, that individual has little to worry about with regard to malpractice liability. The standard of care against which malpractice liability is measured is defined informally as "what a similar doctor would do under similar circumstances." Thus, if most oncologists observe the NCCN guidelines (or if their practice already comports with them), the guidelines will serve as the professional standard against which all oncologists' conduct will be measured. If oncologists ignore the NCCN guidelines, the malpractice standard will continue to reflect the way oncologists actually treat cancer patients.

Critical Pathways↗
PubMed1993

Renal manifestations of AIDS.

The kidneys in patients with acquired immunodeficiency syndrome (AIDS) are subject to a variety of insults. Renal manifestations can be seen with imaging studies of AIDS patients. Computed tomographic (CT) and ultrasound (US) scans of 64 patients with AIDS and renal dysfunction were retrospectively reviewed and compared with clinical, laboratory, and, when available, biopsy results. Imaging abnormalities included increased cortical echogenicity, nephromegaly, pyelonephritis, lobar nephronia, focal masses caused by abscess and lymphoma, parenchymal calcification, hydronephrosis, and infarct. Generally, patients with AIDS as a result of intravenous drug abuse and those with multiple risk factors were more likely to have abnormalities demonstrated at imaging as well as poorer prognosis than were patients in the homosexual transmission group in this series. Although US should be the screening study used in patients with AIDS and suspected renal dysfunction, CT and magnetic resonance imaging may be necessary to identify focal infectious, ischemic, and neoplastic processes.

Acquired Immunodeficiency Syndrome↗
PubMed1993

CT of the azygoesophageal recess in infants and children.

The contour of the azygoesophageal recess (AER) as seen with computed tomography (CT) is an important indicator of mediastinal disorders. Radiologists must recognize, however, that the AER contour varies with patient age. The configuration of the AER is dextroconvex in children younger than 6 years, nonconcave (ie, equally divided between convex and straight) in children aged 6-12 years, and concave (or adult-like) in adolescents and young adults (aged 12-20 years). The cause of this variation is not certain; however, chest wall configuration does not seem to be an important factor. Although a convex AER is normal and common in pediatric patients, this normal appearance must be distinguished from that of mediastinal abnormalities (eg, foregut malformation cysts, vascular anomalies, lymphadenopathy), which can also produce obvious or subtle convexity of the AER. An appreciation for the age-related variation in AER configuration helps in the interpretation of CT scans. Criteria such as attenuation, morphologic characteristics, cephalocaudal extent, and multicompartmental involvement may be helpful in the differential diagnosis, but, generally, mediastinal abnormalities that alter the AER are nonspecific in appearance.

Adolescent↗
PubMed1992

Denial of health care and informed consent in English and American law.

Health care rationing has gained greater visibility in the United States and the United Kingdom, for quite different reasons. As patients in both countries become more aware that potentially beneficial medical services can be denied them on economic--as opposed to purely medical--grounds, they are beginning to seek help from the judiciary. This Article contends that as rationing becomes more explicit, the doctrine of informed consent will come under increased pressure. The Article suggests that courts and legislatures consider imposing a legal obligation on physicians to inform their patients when potentially effective treatment is to be withheld for economic or other non-clinical reasons.

Female↗
PubMed1991

MRI of hepatic iron deposition in patients with renal transplant.

Excess hepatic iron deposition was found in five of 15 (33%) renal transplant patients undergoing magnetic resonance (MR) screening for avascular necrosis of the femoral heads. Only one of these patients had overt liver disease. The number of prior blood transfusions was a significant factor for this deposition, whereas the age and sex of the patients, number and type of transplants, histocompatibility alleles (HLA), and years of hemodialysis and of chronic renal failure were not significant etiological factors. Liver/fat intensity ratios of less than 0.29 on T1-weighted images and ratios of less than 0.21 on T2-weighted images and a calculated T2 value of less than 35 ms were the best indicators of iron overload. Renal transplant patients are at great risk for excess hepatic iron deposition and MR imaging is a promising tool for the diagnosis of iron overload in this patient population.

Adult↗
PubMed1986

Medical malpractice litigation: do the British have a better remedy?

Medical malpractice claims are filed nearly ten times more frequently in America than they are in Great Britain. British patients generally adopt a less adversarial stance toward medical malpractice than do American patients. This Article examines the British malpractice system, as compared with the American system, and explores the differences between the two, in terms of costs and fees, liability rules, statutory provisions, and judicial attitudes toward malpractice litigation. The Article also discusses British social and institutional factors, such as the "taint" of litigation and the National Health Service, and evaluates how these factors affect British malpractice litigation. The Article presents the alternative forums available to British patients in seeking satisfaction for their medical service complaints. The Article concludes with an evaluation of how these factors achieve the three societal objectives of malpractice litigation: reparation, emotional vindication and deterrence.

Attitude↗
PubMed1984

Biological monitoring: the employer's dilemma.

The industrial workplace contains many potential health hazards that not only can cause great harm to workers, but also can destroy the employers' economic stability. Often these hazards are documented and dealth with, but frequently they are unknown. When health-conscious employers monitor the physical well-being of their employees in an effort to avoid the terrible personal and economic costs these hazards can produce, they may be supplying their employees with the documentation necessary to recover financially for their industrial illnesses. This Article analyzes this dilemma confronting employers. It describes the many factors employers must consider when deciding whether to institute a monitoring process that takes full advantage of technological developments in medical care. The Article suggests an approach employers may take until some of the disincentives surrounding the implementation of monitoring are removed.

Civil Rights↗