Angiogram 

What is an angiogram?

An angiogram is a procedure that uses X-ray contrast to look at the blood vessels (arteries or veins) in your body.

Why do we do it?

When blood vessels are blocked, damaged or abnormal in any way, chest pain, heart attack, stroke, or other problems may occur. Angiography helps your physician determine the source of the problem and the extent of damage to the blood vessel segments that are being examined.

Before the test

Lab work may be needed before the angiogram to determine your blood's ability to clot.

 

Chest X-ray 

What is a chest X-ray?

A chest X-ray is a test that uses a small amount of radiation to create an image of the structures within the chest, including the heart, lungs, blood vessels and bones. During an X-ray, a focused beam of radiation is passed through your body, and a black-and-white image is recorded on special film or a computer. The X-ray image that is created looks like a negative from a black and white photograph.

How do I prepare for the test?

There is no special preparation for a chest X-ray. It is important to tell the technologist if you are or may be pregnant. X-rays generally are not used on pregnant women because of the possible risk of radiation exposure to the developing baby.

Before the test begins, you will be asked to remove your clothing--usually just from the waist up--and put on a hospital gown. You also will be asked to remove all jewelry and any other objects containing metal (such as eyeglasses and hair pins). This is done because metal can block the image and interfere with the test results.

 

CT- scan

What is computed tomography?

Computed tomography, commonly known as a CT scan, uses X-rays and computers to produce images of a cross-section of the body. The patient must lie as still as possible as the table moves through the large, donut-shaped scanning device. Movement could blur the images produced by the scanner.

EEG 

What is an EEG?

An electroencephalogram (EEG) is a test during which the electrical signals of the brain are recorded. This electrical activity is detected by electrodes, or sensors, placed on the patient’s scalp and transmitted to a polygraph that records the activity.

How it works

Electrical signals produced by the brain neurons are picked up by the electrodes and transmitted to a polygraph, where they produce separate graphs on moving paper using an ink writing pen or on a computer screen.

DXA 

Dual energy X-ray absorptiometry (DXA)

The most accurate test available for detecting osteoporosis and other bone diseases is dual-energy X-ray absorptiometry (DXA). This test, which takes about 10 to 15 minutes, measures the bone loss in your hips and spine. It also helps your doctor determine how quickly you are losing bone mass, as well as predict your risk of fracture. The test is also used to follow the course of the disease and monitor the effects of various treatments.

Before your DXA test

You do not have to change your daily routine before this test. Eat, drink, and take your medicines as you normally would. However, do not take calcium supplements (such as Tums) for 24 hours before your bone densitometry test. If you think you might be pregnant, notify your doctor.

Knee arthoscopy 

Knee arthroscopy fundamentals


 

Knee arthroscopy is one of the most frequently used procedures for the diagnosis and treatment of knee injuries. This minor surgical procedure is done using an instrument called an arthroscope. While the knee is the joint most often viewed and operated using the arthroscope, other joints such as the shoulder, elbow, ankle, hip and wrist can also be viewed using this instrument.

What are causes of the knee pain?

Injuries, overuse, weakness or aging can harm your knees and cause pain and discomfort.

What are the benefits of knee arthroscopy?

Knee arthroscopy is an effective tool in diagnosing your joint condition and for confirming treatment for knee problems such as meniscus tears and cartilage wear. An arthroscopy can ultimately provide relief from knee pain and improve mobility. Maintaining a normal and active lifestyle with greater comfort is a key benefit of this procedure.

Ultrasound 

What is an ultrasound?

Ultrasound, also known as sonography, or ultrasonography, is a diagnostic procedure that transmits high-frequency sound waves, inaudible to the human ear, through body tissues. The echoes are recorded and transformed into video or photographic images of the internal structures of the body.

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Ultrasound images help in the diagnosis of a wide range of diseases and conditions. The idea for ultrasonography came from sonar technology, which makes use of sound waves to detect underwater objects.

Ultrasound is used to create images of soft tissue structures, such as the gall bladder, liver, heart, kidney, female reproductive organs -- and even of fetuses still in the womb. Ultrasound can also detect blockages in the blood vessels.

Ultrasound may be used with other diagnostic procedures or by itself.

Are there any side effects?

Studies have shown that ultrasound is not hazardous. There are no harmful side effects. In addition, ultrasound does not use radiation, as x-ray tests do.

 

Over the past 20 years there have been immense advances in our understanding of the aetiopathogenesis of RA, and modern molecular genetics has led to the recognition of increasing numbers of genes implicated in the pathogenesis of RA. Advances in medical imaging with magnetic resonance imaging and Doppler ultrasound have led to earlier diagnosisand better quantification of the extent of inflammation. The recognition of the central role of cytokines such as TNFalpha, and interleukin-6, together with T and B lymphocytes, has led to the development of targeted therapies.

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Digital Imaging and Communications in Medicine (DICOM) is a standard for handling, storing, printing, and transmitting information in medical imaging. It includes a file format definition and a network communications protocol. The communication protocol is an application protocol that uses TCP/IP to communicate between systems. DICOM files can be exchanged between two entities that are capable of receiving image and patient data in DICOM format. The National Electrical Manufacturers Association (NEMA) holds the copyright to this standard. It was developed by the DICOM Standards Committee, whose members are also partly members of NEMA

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 DICOM enables the integration of scanners, servers, workstations, printers, and network hardware from multiple manufacturers into a picture archiving and communication system (PACS). The different devices come with DICOM conformance statements which clearly state which DICOM classes they support. DICOM has been widely adopted by hospitals and is making inroads in smaller applications like dentists' and doctors' offices.

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While the DICOM standard has achieved a near universal level of acceptance amongst medical imaging equipment vendors and healthcare IT organizations, the standard has its limitations. DICOM is a standard directed at addressing technical interoperability issues in medical imaging. It is not a framework or architecture for achieving a useful clinical workflow. RSNA's Integrating the Healthcare Enterprise (IHE) initiative layered on top of DICOM (and HL-7) provides this final piece of the medical imaging interoperability puzzle. 

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Ultrasound examination

An ultrasound examination is a noninvasive medical test that helps diagnose and treat medical conditions. Ultrasounds capture the size, structure and shape of parts of the body that cannot be seen using conventional x-rays. An ultrasound exam is crucial in detecting changes or complications in organs, tissues, and vessels or to detect abnormal masses, such as tumors, gallstones, kidney stones, or liver disease by exposing specific body parts to high-frequency sound waves to produce pictures.

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Ultrasound is an oscillating sound pressure wave with a frequency greater than the upper limit of the human hearing range. Ultrasound is thus not separated from 'normal' (audible) sound by differences in physical properties, only by the fact that humans cannot hear it. Although this limit varies from person to person, it is approximately 20 kilohertz (20,000 hertz) in healthy, young adults. Ultrasound devices operate with frequencies from 20 kHz up to several gigahertz.

Ultrasound is used in many different fields. Ultrasonic devices are used to detect objects and measure distances. Ultrasonic imaging (sonography) is used in both veterinary medicineand human medicine. In the nondestructive testing of products and structures, ultrasound is used to detect invisible flaws. Industrially, ultrasound is used for cleaning and for mixing, and to accelerate chemical processes. Animals such as bats and porpoises use ultrasound for locating prey and obstacles.

News

Nobel Prize Announcement

October 9, 2014

Oxford Medicine Online is proud to publish some previous Nobel Prize winners, a number of whom contributed to the The Oxford Textbook of Medicine (5 ed.).

Aaron Klung, The Nobel Prize in Chemistry, 1982
For his development of crystallographic electron microscopy and his structural elucidation of biologically important nucleic acid-protein complexes

Author of the Foreword to the Oxford Textbook of Medicine (5 ed.)

Amartya Sen, The Nobel Memorial Prize in Economic Sciences, 1998
For his contribution to welfare economics

Author of Chapter 3.5 ‘Human Disasters’ in the Oxford Textbook of Medicine (5 ed.)

Sydney Brenner, The Nobel Prize in Physiology or Medicine, 2002
Awarded jointly to Sydney Brenner, H. Horvitz and John E. Sulston for their discoveries concerning genetic regulation of organ development and programmed cell death

Author of Chapter 4.2.1 ‘The Human Genome Sequence’ in the Oxford Textbook of Medicine (5 ed.)

Sir Martin J. Evans, The Nobel Prize in Physiology or Medicine, 2007
Awarded jointly to Mario R. Capecchi, Sir Martin J. Evans and Oliver Smithies for their discoveries of principles for introducing specific gene modifications in mice by the use of embryonic stem cells

Author of Chapter 4.7 ‘Discovery of Embryonic Stem Cells and the Concept of Regenerative Medicine’ in the Oxford Textbook of Medicine (5 ed.)

John O’Keefe, May-Britt Moser, and Edvard I. Moser, The Nobel Prize in Physiology or Medicine, 2014 
For their discoveries of cells that constitute a positioning system in the brain. 

Cost-effectiveness of CT

Cost-effectiveness of CT screening in the national lung screening trial
New England Journal of Medicine, 11/07/2014  Exclusive Author                                                                               Commentary  Evidence Based Medicine Clinical Article Black WC, et al. – The National Lung Screening Trial (NLST) showed that screening with low–dose computed tomography (CT) as compared with chest radiography reduced lung–cancer mortality. Authors examined the cost–effectiveness of screening with low–dose CT in the NLST. They estimated that screening for lung cancer with low–dose CT would cost $81,000 per QALY gained, but they also determined that modest changes in our assumptions would greatly alter this figure. The determination of whether screening outside the trial will be cost–effective will depend on how screening is implemented.

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