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Biomedical subjects

J B Lightfoote

Publications and source records attributed to J B Lightfoote.

8 recordsLinked to original sources
PubMed2000

Economic and outcomes assessment of magnetic resonance imaging in the evaluation of headache.

We sought to evaluate the economic impact and diagnostic utility of magnetic resonance imaging (MRI) in the management of patients with headache and nonfocal physical examinations. Computerized medical records were retrospectively reviewed of 1,233 patients presenting for MRI of headache at our institution over a 3-year period (1992-1995). Patients with focal findings at physical examination, prior brain surgery, head trauma, or immunocompromise were excluded. A model was developed to assess the cost associated with the MR test results, and actual average institutional costs of performing an examination applied. Correlative statistical analysis of referring specialties and positive tests was also performed. Three hundred twenty-eight patients who met the above criteria were retained in the sample. One hundred sixty-three patients (50%) had negative MR test results. Of the 50% of patients with positive studies, only 5 (1.5%) had clinically significant MR results. The average cost of an MR examination was 517 dollars (1998 dollars). The cost per clinically significant managed case detected was 34,535 dollars. No statistically significant difference was found among referring specialties and clinically significant MR results. Our results indicate that MRI of nonfocal headache yields a low percentage of positive clinically significant results and has limited cost-effectiveness. Referring specialty had no significant bearing on these outcomes, regardless of specialist experience.

Adolescent↗
PubMed1996

Single-payer health insurance systems: national myths and immovable mountains.

Leaders in both government and the health-care industry have strong and varied opinions regarding the present US health-care system, but concur that health-care financing and organization need restructuring. The single-payer system offers the best framework for improving health-care universality, delivery, quality, access, choice, and cost effectiveness. However, the single-payer alternative often is dismissed early in debates on health-care reform. Popular aversion to collective governmental funding of health-care costs and the economic interests of the management, insurance, information, and profit sectors of the health-care industry are the critical impediments to adoption of single-payer insurance systems. This article examines the psychosocial and economic obstacles that prevent development of an efficient and effective health-care system and preclude recognition of the single-payer system as the best answer to health-care reform.

Developed Countries↗
PubMed1985

Digital subtraction ductography.

Digital subtraction techniques used in the examination of eight patients with salivary and nasolacrimal disease are described. Pleomorphic adenoma, ductal stricture, extrinsic masses, parotid-otic fistula, and a radiolucent calculus were demonstrated. The procedures are more easily performed than film techniques, and pathology is better demonstrated by digital ductography than on a film examination. Image subtraction, reregistration, and window manipulation allowed clear demonstration of ducts about the head and neck, overcoming limitations imposed by inherently high object contrast. Digital subtraction ductography is an important nonvascular application of digital imaging technology.

Adult↗
PubMed1985

Digital tomography: description and preliminary clinical experience.

Digital tomography was performed in 30 patients using a new prototype system with a PET-Scope image tube. Twenty-eight exposures are obtained during a single revolution of the x-ray source over the volume of tissue to be imaged. The sum of the radiation produced by the 28 exposures is about equivalent to a single routine exposure of the part imaged. The data accumulated can provide up to 200 tomographic sections at intervals of 5 mm. Reconstruction time for each section is 3 sec. The raw images may be reconstructed as often as desired. Algorithms are being developed to allow axial and sagittal reformations. Further work is required to improve spatial resolution and contrast and to develop algorithms to allow subtraction of blurred images above and below the reconstructed site. The authors believe that digital tomography may eventually replace most routine tomograms.

Adult↗
PubMed1984

Trephine bone biopsy system: a refined needle for radiologists.

A new type of bone biopsy unit that uses standard engineering and machinery principles of self cleaning and clearance allows for greater ease and more accurate performance of biopsy. Its use consistently yields excellent biopsy material. Included is a semi-rigid K wire, which may be used with a drill, for ease of insertion and a stylet in a cannula, which allows for multiple biopsies without reinsertion. The needle is compared with standard saw tips (trephines) and sharpened cannulas.

Biopsy, Needle↗
PubMed1975

Should tonometry screening be done by technicians instead of physicians?

A random sample of 768 clinic patients 40 years or older were screened by a technician utilizing Schlotz tonometry. All patients with an intraocular pressure of 20 mm Hg or more were referred for ophthalmological evaluation. The prevalence of frank glaucoma and suspected glaucoma in this infirm population was 1.8% and 2.5%, respectively. The cost of detecting frank or suspected glaucoma decreased in the second half of the study due to a decrease in the number of false-positive tests. These findings suggest that all clinic patients 40 years or older should be screened for glaucoma. Because many internists are reluctant to screen for glaucoma and because there are large number of false-positive tests by those who do tonometry episodically, we suggest that technicians do glaucoma screening.

Adult↗