An audit of delays in diagnosis and treatment of lymphoma in district hospitals in the northern region of the United Kingdom

2000 ◽  
Vol 22 (3) ◽  
pp. 157-160 ◽  
Author(s):  
G.P. Summerfield ◽  
P.J. Carey† ◽  
M.J. Galloway† ◽  
H.N. Tinegate§
1960 ◽  
Vol 14 (2) ◽  
pp. 323-328 ◽  

The Trusteeship Council held its tenth special session at UN Headquarters on December 4 and 16, 1959. Following the adoption of its agenda, the Council entered into consideration of the report of the UN Plebiscite Commissioner on the plebiscite in the northern part of the trust territory of the Cameroons under United Kingdom administration. In introducing the first part of the report, Mr. Abdoh, UN Plebiscite Commissioner, reviewed the history of his consultations with the United Kingdom government on arrangements for the organization of the plebiscite. He observed that, as a result of being administered for many years as an integral part of the northern region of Nigeria, the Northern Cameroons had previously had very little reality as a separate administrative entity; in fact, boundaries with the northern region of Nigeria had little significance, and tribal groups extended from that region into the trust territory and even beyond, to the Cameroons under French administration. Communications in the Northern Cameroons were poor, but, despite adverse conditions, the UN plebiscite staff had travelled extensively and had been able to meet both the people and their leaders. Mr. Abdoh added that he wished to stress the peaceful and orderly way in which polling had been conducted throughout the territory, and mentioned the results of the plebiscite, viz.: out of the 113,859 votes cast, 70,546 had been in favor of deciding the future of the Cameroons at a later date (alternative b), while 42,788 had indicated a preference for the Northern Cameroons' becoming a part of the northern region of Nigeria when Nigeria became independent (alternative a); 525 votes had been rejected. Approximately 80 percent of the estimated number of potential electors, and nearly 88 percent of the voters actually registered, had participated in the balloting; thus the greater part of the eligible population had taken part in the consultation, freely expressing their wishes in regard to the alternatives offered in the plebiscite. Mr. Abdoh had, however, felt it his duty to inform the Council of the view, which seemed to be prevalent among those who had voted for the second alternative, that the plebiscite had offered the people an opportunity of registering what was in effect a protest against the system of local adminstration, the introduction of reforms into which was apparently long overdue.


Author(s):  
Fraser Birrell ◽  
Janice O’Connell

In this chapter, we describe how the process of ageing can itself affect the diagnosis and treatment of musculoskeletal conditions. We outline general principles concerning the clinical presentation of rheumatological diseases in older patients, as well as providing specific guidance on the diagnosis and management of the commoner conditions encountered in practice in the United Kingdom.


1993 ◽  
Vol 4 (1) ◽  
pp. 41-42
Author(s):  
A R Markos ◽  
A A H Wade ◽  
M Walzman

A national survey of the methods used in the diagnosis and treatment of cervical intraepithelial neoplasia (CIN) in the departments of genitourinary medicine (GUM) in the United Kingdom had been conducted through a postal questionnaire. The findings indicate that at present of 157 responders to the questionnaire, 43 (27.3%) take an active part in the management of CIN. The different modes of management and follow-up are presented.


2020 ◽  
Vol 11 ◽  
pp. 215013271989475
Author(s):  
Honey Thomas ◽  
Louise Smyth

Many patients are prescribed anticoagulants. Newer non–vitamin K oral anticoagulants, NOACs, were launched in 2008 and are increasingly commonly used. However, they may still be unfamiliar to patients and health care professionals. It is mandated by the National Patient Safety Agency and European Society of Cardiology to provide written safety information for patients receiving anticoagulants. We developed a standard patient alert card with the support of the North of England Strategic Clinical network (NESCN) to clearly provide key safety information for patients and health care professionals. This is the only card in the United Kingdom that is used over such a wide geographical area. We recognized that this would avoid duplication of work devising a similar card across all the sites in primary and secondary care. Given that staff and patients commonly move about the region it would also lead to better ease of recognition. The NESCN card was developed with input from all the key stakeholders, including cardiology, stroke, hematology, acute medicine, primary care, and patient groups. It was launched in 2015 across the Northern region, which includes over 3 million people. It was distributed to general practitioners (GPs), primary and secondary care pharmacists. Electronic and face-to-face education was carried out alongside to pharmacists, GPs, and hospital physicians. We gathered patient and clinical staff feedback regarding the card and found the alert card was widely embedded within practice across the region and patient feedback was good. The evaluation shows a simple and inexpensive intervention delivered with no formal funding can address this patient safety concern. We have engaged with Clinical Commissioning Groups and secondary care trusts in the region to ensure the legacy of the project. In response to requests from other regions and organizations, the card has been widely shared and implemented across many areas of the United Kingdom.


1983 ◽  
Vol 10 (4) ◽  
pp. 171-177 ◽  
Author(s):  
R. T. Broadway

Presidential address to the British Society for the Study of Orthodontics, November 9th 1981. A review of the changes in orthodontic diagnosis and treatment in the United Kingdom over the last 35 years.


2018 ◽  
Vol 100-B (1) ◽  
pp. 119-124 ◽  
Author(s):  
C. Broderick ◽  
S. Hopkins ◽  
D. J. F. Mack ◽  
W. Aston ◽  
R. Pollock ◽  
...  

Aims Tuberculosis (TB) infection of bones and joints accounts for 6.7% of TB cases in England, and is associated with significant morbidity and disability. Public Health England reports that patients with TB experience delays in diagnosis and treatment. Our aims were to determine the demographics, presentation and investigation of patients with a TB infection of bones and joints, to help doctors assessing potential cases and to identify avoidable delays. Patients and Methods This was a retrospective observational study of all adults with positive TB cultures on specimens taken at a tertiary orthopaedic centre between June 2012 and May 2014. A laboratory information system search identified the patients. The demographics, clinical presentation, radiology, histopathology and key clinical dates were obtained from medical records. Results A total of 31 adult patients were identified. Their median age was 37 years (interquartile range (IQR): 29 to 53); 21 (68%) were male; 89% were migrants. The main sites affected were joints (10, 32%), the spine (8, 26%) and long bones (6, 19%); 8 (26%) had multifocal disease. The most common presenting symptoms were pain (29/31, 94%) and swelling (26/28, 93%). ‘Typical’ symptoms of TB, such as fever, sweats and weight loss, were uncommon. Patients waited a median of seven months (IQR 3 to 13.5) between the onset of symptoms and referral to the tertiary centre and 2.3 months (IQR 1.6 to 3.4.)) between referral and starting treatment. Radiology suggested TB in 26 (84%), but in seven patients (23%) the initial biopsy specimens were not sent for mycobacterial culture, necessitating a second biopsy. Rapid Polymerase Chain Reaction-based testing for TB using Xpert MTB/RIF was performed in five patients; 4 (80%) tested positive for TB. These patients had a reduced time between the diagnostic biopsy and starting treatment than those whose samples were not tested (median eight days versus 36 days, p = 0.016). Conclusion Patients with bone and joint TB experience delays in diagnosis and treatment, some of which are avoidable. Maintaining a high index of clinical suspicion and sending specimens for mycobacterial culture are crucial to avoid missing cases. Rapid diagnostic tests reduce delays and should be performed on patients with radiological features of TB. Cite this article: Bone Joint J 2018;100-B:119–24.


Author(s):  
Fraser Birrell ◽  
Janice O’Connell

In this chapter, we describe how the process of ageing can itself affect the diagnosis and treatment of musculoskeletal conditions. We outline general principles concerning the clinical presentation of rheumatological diseases in older patients, as well as providing specific guidance on the diagnosis and management of the commoner conditions encountered in practice in the United Kingdom.


1993 ◽  
Vol 107 (7) ◽  
pp. 614-617 ◽  
Author(s):  
J. P. Davis ◽  
P. R. Prinsley ◽  
P. J. Robinson

Mycobacterial cervical lymphadenopathy is relatively uncommon in the United Kingdom; when cases do occur opportunities for early diagnosis and treatment may be missed. We have reviewed twenty-three cases of mycobacterial cervical lymphadenopathy presenting to an urban general hospital over a four-year period. We discuss the techniques available to aid a diagnosis of mycobacterial disease and suggest a protocol to allow efficient use of these techniques.


Author(s):  
Fraser Birrell ◽  
Janice O’Connell

In this chapter, we describe how the process of ageing can itself affect the diagnosis and treatment of musculoskeletal conditions. We outline general principles concerning the clinical presentation of rheumatological diseases in older patients, as well as providing specific guidance on the diagnosis and management of the commoner conditions encountered in practice in the United Kingdom.


Author(s):  
Aleesha Karia ◽  
Reza Zamani ◽  
Mohammad Akrami

Socio-economic factors affecting health care can lead to delays in diagnosis of neurological conditions, consequentially affecting treatment and morbidity rates. This inequality in health care can leave patients from lower socio-economic backgrounds more vulnerable to a poorer quality of care from health care providers in the United Kingdom (U.K.). Aims: In this systematic review, we assess the impact of socio-economic status on the use of diagnostic neuroimaging in the U.K., measured by the timeliness, accessibility and appropriate use of computed tomography (CT), magnetic resonance imaging (MRI), ultrasonography, electroencephalography (EEG) and single-photon emission computed tomography (SPECT). We specifically evaluate the non-surgical use of neuroimaging techniques as this relies on the judgment of primary care-givers (e.g., doctors and radiologists), where health disparities are most common. This study includes the analysis of diagnostic imaging used for dementia, minor head injury, stroke, cancer, epilepsy, chronic inflammatory demyelinating polyneuropathy and Parkinson’s disease. With this study, we aim to assess the health inequalities at disease diagnosis. Methods: Using Medline (via Ovid), PubMed and Web of Science databases as sources of information, we critically appraise existing studies on neuroimaging use in the U.K. health care system, published between January 2010 and February 2021. Findings: A total of 18 studies were included in this research, revealing that there was an increase in patients of Black and Asian communities diagnosed with dementia and at an earlier age. There was little evidence to suggest that a lack of access to diagnostic imaging is associated with socio-economic status. However, there are data to suggest that people of a lower socio-economic background require more specialist services with diagnostic neuroimaging tools. In addition, there is evidence to suggest that diagnostic neuroimaging techniques could be utilised more effectively by health care workers to prevent unnecessary delays in diagnosis for patients in lower socio-economic areas.


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