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Biomedical subjects

W F Mason

Publications and source records attributed to W F Mason.

14 recordsLinked to original sources
PubMed1998

Telemedicine in Nova Scotia: report of a pilot study.

OBJECTIVE: To provide and evaluate telemedicine services for rural physicians and patients in Nova Scotia. MATERIALS AND METHODS: As a pilot project, three telemedicine services (videoconference continuing medical education [CME], teledermatology, and teleradiology) were provided to four hospitals in Nova Scotia communities. All four sites received CME (a total of 269 physicians, 53 other health care professionals); three sites received teledermatology (66 consultations), and two sites received teleradiology (808 radiologic examinations). At the consulting site, 12 faculty members presented 24 one-hour videoconferences, and there was one consulting radiologist and dermatologist. Each service was evaluated independently. Methods included participant questionnaires; focus groups; numbers and categories of participants or examinations; comparison of operational costs, capitol costs (teledermatology and teleradiology), and travel costs (CME); technical assessments of hardware, software, and telecommunications; assessment of clinical diagnostic procedures (teledermatology); and comparative study of original and digitized films (teleradiology). RESULTS: Despite growing pains, the technologies effectively provided the three services: the services were acceptable to referring and consulting physicians and patients. Improvements in patient care and outcomes comparable to those of traditional methods were demonstrated in teleradiology and teledermatology, especially for emergencies. Physician access to CME and patient access to dermatology consultation services were improved. Financial savings were demonstrated for CME, but further investigation is required to determine the savings attributable to teleradiology and teledermatology. CONCLUSIONS: The telemedicine services supported rural physicians, their patients, and their communities. Although telemedicine is not a panacea for all concerns of rural physicians, the pilot project provided a strong foundation for further development and study.

Adolescent↗
PubMed1990

A comparative study of the nephrotoxicity of iohexol, iopamidol and ioxaglate in peripheral angiography.

Iohexol (Omnipaque 350) and iopamidol (Isovue 370) are nonionic monomers; ioxaglate (Hexabrix 320) is an ionic dimer. We compared the nephrotoxicity of these three media by a prospective double-blind evaluation in 500 patients who underwent peripheral angiography during a 6-month period. Serum creatinine levels were determined before injection of the contrast medium and 72 hours after in 478 patients. In 308 (64%) patients there was an average increase in the serum creatinine level of 18.1 mumol/L after injection of an average volume of 123 ml of contrast medium. A subset of 80 patients who had an elevated baseline creatinine level (more than 110 mumol/L) had an average increase in the serum creatinine level of 40.45 mumol/L. Of patients who had arterial injections, 182 (72%) had an increase in serum creatinine level (20.7 mumol/L), but of those who had peripheral venous injections, only 43 (45%) had an elevated creatinine level (9.2 mumol/L), and of those who had central venous injections, 83 (63.8%) had an elevated level (17.0 mumol/L). In most patients elevation of the serum creatinine level was not of clinical importance. High-risk patients with an elevated serum creatinine level were found to be most vulnerable to contrast nephrotoxicity. Although mean differences were not statistically significant, there were consistent trends which suggested that ioxaglate was the least nephrotoxic of the three agents studied.

Acute Kidney Injury↗
PubMed1985

Therapeutic embolization of the hepatic artery.

We have performed therapeutic embolization of the hepatic artery and its branches in 15 patients, 14 with metastatic neoplasm and one with postoperative hepatobiliary hemorrhage. In the latter patient, bleeding ceased on embolization of the right hepatic artery and did not recur. The median survival time of the 14 patients who had hepatic embolization was six months. The mean survival time in our three patients with metastatic gastric leiomyosarcoma was 24 months, whereas our five patients with metastases from carcinoma of the colon had a mean survival time of only five months. On the basis of this experience we conclude that hepatic artery embolization is advisable in patients with hormonal effects of metastatic disease and in patients with massive hepatomegaly related to metastases from gastric leiomyosarcomas, and may be indicated in patients with hepatic artery hemorrhage.

Adult↗
PubMed1983

Digital subtraction arteriography (DSA) in re-evaluation of angioplasties.

Digital subtraction arteriography (DSA) permits accurate, objective, and relatively pain-free evaluation of the morphology of angioplasty sites. During 1982, we performed DSA on 74 patients who had had 96 angioplasties over the previous three and one-half years. All of the DSA examinations were of diagnostic quality. We were surprised to find that 15% of angioplasty sites had undergone restenosis and, in addition, 12% of patients had new lesions. Because most of those patients were asymptomatic, such lesions would not have been detected by clinical assessment alone. Our angioplasty results compare favorably with other reported series. It is expected that DSA will play an increasingly important role in re-evaluation following treatment by angioplasty or surgery.

Angiography↗
PubMed1983

Digital subtraction arteriography in the diagnosis of renovascular hypertension.

Renal digital subtraction arteriography (RDSA) is a relatively safe, simple, and inexpensive means of detecting the presence of renovascular disease in hypertensive patients. We report our own 15-month experience with RDSA, performed on 166 patients because of hypertension, and review the literature. Twenty-eight of the patients had arteriography. Using this as a measure, the sensitivity of RDSA was 83% and its specificity 96%. RDSA findings are usually conclusive. Addition of plain films following the procedure permits evaluation of renal parenchyma, collecting systems, ureters, and bladder. Arteriography should be reserved for those patients with positive RDSA to be treated by surgery or angioplasty, and for the small number of patients who have a non-diagnostic RDSA. If renal vein renin sampling is done first, RDSA may be performed at the same time. As RDSA becomes more available there will be little place for rapid sequence urography in the investigation of hypertension. In patients suspected of having renovascular hypertension, the primary mode of investigation should be renal DSA.

Catheterization↗
PubMed1978

Renal arteriography in von Hippel-Lindau Diease.

Since 1960, 17 patients with von Hippel-Lindau disease have had cerebellar hemangioblastomas removed at the Victoria General Hospital, Halifax, Nova Scotia. The 4 most recent patients have had renal arteriography as a part of their investigation. Though 3 of these had negative urography, all 4 had positive findings on arteriography. The first patient had bilateral renal cell carcinomas and cysts and failed to respond to 1 year of 'Laetrile' therapy; the second had small cysts in each kidney; the third had bilateral renal cysts, multiple left renal cell carcinomas and a clinically unsuspected right pheochromocytoma; the fourth had a small renal cell carcinoma. It is recommended that all patients with von Hippel-Lindau disease and siblings with any manifestations of the disease have renal arteriography as part of their early investigation.

Adenocarcinoma↗
PubMed1977

Angiography in gastointestinal bleeding.

Over a four-year period, eight patients with documented gastrointestinal bleeding had angiography as a part of their investigation and treatment at the Department of Radiology, Victoria General Hospital, Halifax, Nova Scotia. A review of these eighty cases has been carried out and angiography has been found to be both safe and reliable in the diagnosis of gastrointestinal bleeding. Cautiously administered intra-arterial pitressin infusion therapy will arrest bleeding in about one-third of cases and in most others will reduce blood loss so that a critically ill patient may be made more fit for subsequent surgery. Patients who have recently received intravenous pitressin should not be given intra-arterial pitressin.

Aged↗
PubMed1977

Arteriography in malignant neoplasms of the bowel.

Eighty patients with gastrointestinal bleeding were investigated by angiography over a four-year period. Nine had malignant neoplasms of the bowel. Inconspicuous neovascularity was the most constant finding, best seen in leiomyosarcoma of the small bowel and adenocarcinoma of the colon. Neovascularity was not seen in a patient with reticulum cell sarcoma of colon detected by extravasation. When other studies including endoscopy and barium examinations have failed to explain acute or chronic bleeding, an appreciable number of intestinal neoplasms may be demonstrated by arteriography.

Adenocarcinoma↗