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Old Dog With New Tricks: 99mtc-Sestamibi Spect-Ct For Renal Mass Differentiation, Zachary Beswick, Ishani Dalal May 2019

Old Dog With New Tricks: 99mtc-Sestamibi Spect-Ct For Renal Mass Differentiation, Zachary Beswick, Ishani Dalal

Teaching and Education

Small renal masses have historically presented a diagnostic challenge for radiologists and urologists. MRI and CT have a limited capability to differentiate benign and malignant small solid renal masses. The relatively poor negative predictive value of renal biopsy limits the ability to avoid surgical resection in small renal masses with negative biopsy. 99mTc-sestamibi SPECT-CT can be an important tool in directing the management of patients with renal masses.We present the analysis of 99mTc-sestamibi uptake patterns in patients with small renal masses who underwent further characterization of these masses with 99mTc-sestamibi SPECT-CT. Pertinent interpretation points in differentiating renal cell carcinoma ...


Front Matter Mar 1992

Front Matter

Henry Ford Hospital Medical Journal

No abstract provided.


Urban Health Solutions In The 1990s: No Time For False Promises, Seth Foldy Mar 1992

Urban Health Solutions In The 1990s: No Time For False Promises, Seth Foldy

Henry Ford Hospital Medical Journal

No abstract provided.


Urban Health Care: Solutions For The 1990s, David R. Nerenz, David W. Benfer Mar 1992

Urban Health Care: Solutions For The 1990s, David R. Nerenz, David W. Benfer

Henry Ford Hospital Medical Journal

No abstract provided.


Health Care Linkage Project: Improving Access To Care, Martha G. Ferguson, Lon Berkeley, Louis Fourcher, Belinda Guyton, Linda Ross Reiner Mar 1992

Health Care Linkage Project: Improving Access To Care, Martha G. Ferguson, Lon Berkeley, Louis Fourcher, Belinda Guyton, Linda Ross Reiner

Henry Ford Hospital Medical Journal

The primary objective of the Health Care Linkage Project, funded by a grant from the Chicago Community Trust, is to develop, implement, and evaluate a primary health care linkage network within the city of Chicago that creates formalized linkages between community health centers, the Chicago Department of Health clinics, and hospitals. Six linkage networks are currently operational, with an additional two sites phased in during 1991. The success of the pilot project has been demonstrated by hundreds of patients receiving primary care and ancillary services on a more timely basis, by greater coordination between the public and private sector, by ...


Federal, State, And Local Partnerships In Providing Primary Care: One Urban Health Department's Endeavor With A State University Medical Center, Joy L. Getzenberg, D. Patrick Lenihan Mar 1992

Federal, State, And Local Partnerships In Providing Primary Care: One Urban Health Department's Endeavor With A State University Medical Center, Joy L. Getzenberg, D. Patrick Lenihan

Henry Ford Hospital Medical Journal

We describe how the federal government, the City of Chicago, and the State of Illinois worked together to increase the availability and accessibility of health care services on Chicago's underserved west side by reopening a bankrupt, federally-funded community health center. The federal government made the building available to the City which then contracted with a state university medical center to be the provider of services. This partnering has allowed the Chicago Department of Health to offer services in a previously underserved area. The University has gained an opportunity for community-based primary care teaching, as well as community relations. Patients ...


Public Health Care Delivery In Five U.S. Municipalities: Lessons And Implications, David G. Whiteis, J. Warren Salmon Mar 1992

Public Health Care Delivery In Five U.S. Municipalities: Lessons And Implications, David G. Whiteis, J. Warren Salmon

Henry Ford Hospital Medical Journal

Increasing pressures on private and public hospitals have necessitated a reassessment of urban health care delivery. Patients left unserved by stressed private hospitals have placed a greater burden on public institutions, which themselves are often old, underfunded, and in danger of closure. As policy analysts consider remedies, primary care in community-based settings has reemerged as an important component of planning. We present results of a comparative analysis of five public health care delivery systems (Boston, Dallas, Denver, Milwaukee, and Seattle), reflecting their economic, political, and cultural dynamics. Although significant differences in the relative centralization of care and reliance on community-based ...


Training The Urban Health Care Provider: One Department's First Steps, James Schindler Mar 1992

Training The Urban Health Care Provider: One Department's First Steps, James Schindler

Henry Ford Hospital Medical Journal

As our country faces a national crisis in health care, few have outlined plans to improve the shortage of primary care physicians. This is especially critical in urban areas where sociocultural impacts on health are large. The Department of Family Practice and Community Medicine at the University of Texas School of Medicine in Houston has begun development of a division of Urban Family Medicine to address the special training needs of the urban family practitioner. Subdivisions that have been formed focus on undergraduate curriculum, graduate educational strategies, service, and research and policy to further develop the training model.


Urban Health And The Social Contract: Poverty, Race, And Death, H. Jack Geiger Mar 1992

Urban Health And The Social Contract: Poverty, Race, And Death, H. Jack Geiger

Henry Ford Hospital Medical Journal

No abstract provided.


Urban Health Care: An Integral Part Of The United States Health Care System, Sander M. Levin Mar 1992

Urban Health Care: An Integral Part Of The United States Health Care System, Sander M. Levin

Henry Ford Hospital Medical Journal

No abstract provided.


Universal Health Care For Americans, Frank Clemente Mar 1992

Universal Health Care For Americans, Frank Clemente

Henry Ford Hospital Medical Journal

No abstract provided.


Pace: A Capitated Model Towards Long-Term Care, John Shen, Ann Iverson Mar 1992

Pace: A Capitated Model Towards Long-Term Care, John Shen, Ann Iverson

Henry Ford Hospital Medical Journal

No abstract provided.


Community Health Centers: A Resource For Service And Training, Joan Hedgecock, Maria Castro, William B. Cruikshank Mar 1992

Community Health Centers: A Resource For Service And Training, Joan Hedgecock, Maria Castro, William B. Cruikshank

Henry Ford Hospital Medical Journal

The American Medical Student Association (AMSA) Foundation is assisting the U.S. Public Health Service in increasing the number of primary care physicians trained and committed to practice in medically underserved areas. In collaboration with the American Academy of Family Physicians, the Ambulatory Pediatrics Association, and the Society of General Internal Medicine, AMSA conducted an assessment of federally-funded residency programs to identify and describe their affiliations with federally-funded community and migrant health centers (CIMHCs). Of the 260 programs assessed and the 147 responses, 125 offer community-based training. Of these, 73 offer training in primary care centers and 39 offer training ...


Health Care Consortia: A Mechanism For Increasing Access For The Medically Indigent, Patricia A. Caplan, Bonnie Lefkowitz, Lynn Spector Mar 1992

Health Care Consortia: A Mechanism For Increasing Access For The Medically Indigent, Patricia A. Caplan, Bonnie Lefkowitz, Lynn Spector

Henry Ford Hospital Medical Journal

In response to poor coordination among health and social service providers, health care consortia have emerged in many areas of the United States. Consortia link multiple providers in a common structure to create comprehensive systems of care. They can he formally structured or informal combinations of providers that engage in coordination hut otherwise do not comprise an independent organization. The functions most common among all types of consortia are shared services and service coordination; however, a number of consortia also operate outreach/education programs. Consortia represent an innovative response to the need both for vertical integration—case management of all ...


The Structure And Function Of Urban Pharmacies: Visits To Community Pharmacies In Inner-City Chicago, Thomas J. Reutzel, Laura A. Wilson Mar 1992

The Structure And Function Of Urban Pharmacies: Visits To Community Pharmacies In Inner-City Chicago, Thomas J. Reutzel, Laura A. Wilson

Henry Ford Hospital Medical Journal

Visits were made to 21 pharmacies in two poor neighborhoods on the west side of Chicago and interviews conducted with pharmacists-in-charge. The objective of the study was to provide a comprehensive description of the function, capabilities, and problems of urban pharmacy. We present results on the structure and function of these inner-city pharmacies. The pharmacies fit one of three structural forms: chain, independent, or medical center. The majority of respondents viewed the function of the inner-city pharmacy as patient-centered but also identified several barriers to effective patient communication. The results suggest that inner-city physicians and pharmacists should communicate with patients ...


Health Priorities Of The State Of Michigan, Vernice Davis Anthony Mar 1992

Health Priorities Of The State Of Michigan, Vernice Davis Anthony

Henry Ford Hospital Medical Journal

No abstract provided.


Moving From Health Care Research To Action, Claudia R. Baquet, Katherine Marconi, George Alexander Mar 1992

Moving From Health Care Research To Action, Claudia R. Baquet, Katherine Marconi, George Alexander

Henry Ford Hospital Medical Journal

Although the United States spends more on health care than any country in the world, access to that care is becoming increasingly difficult. The National Cancer Institute and other federal agencies are sponsoring innovative research for delivering effective medical services, particularly to underserved populations. Models of successful collaboration between private and public sectors concerned with health care can be adapted and implemented at the national, state, and local levels. However, other measures are needed to ensure access to adequate health care for all Americans. Minimal but effective regulations are needed to ensure quality control, reduce duplication of services, and minimize ...


Mount Sinai: A Special Hospital For A Special Community, Benn Greenspan Mar 1992

Mount Sinai: A Special Hospital For A Special Community, Benn Greenspan

Henry Ford Hospital Medical Journal

No abstract provided.


The Urban Hospital: Rediscovering Abandoned Values, Thomas W. Chapman Mar 1992

The Urban Hospital: Rediscovering Abandoned Values, Thomas W. Chapman

Henry Ford Hospital Medical Journal

No abstract provided.


Urban Hospitals: Their Plight And Mission, Jeffrey C. Merrill, Elliott C. Roberts, Mary Corita Heid Mar 1992

Urban Hospitals: Their Plight And Mission, Jeffrey C. Merrill, Elliott C. Roberts, Mary Corita Heid

Henry Ford Hospital Medical Journal

No abstract provided.


Adenocarcinoma Of The Prostate: Overview Ii, Joseph C. Cerny Mar 1992

Adenocarcinoma Of The Prostate: Overview Ii, Joseph C. Cerny

Henry Ford Hospital Medical Journal

No abstract provided.


The Epidemiology Of Prostate Cancer In Black Men, David A. Burks, Ray H. Littleton Mar 1992

The Epidemiology Of Prostate Cancer In Black Men, David A. Burks, Ray H. Littleton

Henry Ford Hospital Medical Journal

Data on the epidemiology of prostate cancer from the 1930s to the present document a dramatic racial difference in incidence, survival, and mortality rates in American men. American black men have the highest incidence and mortality rates of prostate cancer in the world. Survival data have been related to access to medical care, genetic and environmental factors, and cultural differences, including diet and social habits. Most reports present conflicting data with no clear positive correlations, and conclusions are often speculative. Better controlled, prospective studies of epidemiologic variables and a comprehensive genetic evaluation of black families with prostate cancer are needed ...


The Current Role Of Prostatic Acid Phosphatase And Prostate-Specific Antigen In The Management Of Prostate Cancer, Sugandh D. Shetty, Joseph C. Cerny Mar 1992

The Current Role Of Prostatic Acid Phosphatase And Prostate-Specific Antigen In The Management Of Prostate Cancer, Sugandh D. Shetty, Joseph C. Cerny

Henry Ford Hospital Medical Journal

No abstract provided.


An Update On The Role Of Ploidy In Prostate Carcinoma, Jill M. Peters-Gee Mar 1992

An Update On The Role Of Ploidy In Prostate Carcinoma, Jill M. Peters-Gee

Henry Ford Hospital Medical Journal

One of the characteristic features of prostate carcinoma is its marked variation in biologic behavior. DNA quantitation has been studied in prostate carcinoma using a variety of techniques. Evaluation of tumor ploidy suggests that this may be the best predictor of the biologic behavior of prostate cancer in individual patients. This comprehensive review addresses the current studies, stage by stage, to clarify the clinical significance of these findings.


Therapeutic Options For Localized Carcinoma Of The Prostate: The Role Of External Beam Radiation Therapy, Mark S. Khil, Jae Ho Kim Mar 1992

Therapeutic Options For Localized Carcinoma Of The Prostate: The Role Of External Beam Radiation Therapy, Mark S. Khil, Jae Ho Kim

Henry Ford Hospital Medical Journal

During the last three decades the use of ionizing radiation, both external beam radiotherapy and interstitial radionuclide implant (brachytherapy), has greatly increased for the treatment of cancer of the prostate. The increased use of radiation therapy is in part due to the technological advance of high-energy megavoltage units as well as the steadily improving long-term results of radiotherapy. Because of the comparable tumor control rates, patients with early stage prostate cancer have several therapeutic options for curative treatment including radical prostatectomy, external beam radiation therapy, and interstitial brachytherapy. The role of external beam radiotherapy is discussed in terms of the ...


Radical Surgery In The Treatment Of Localized Carcinoma Of The Prostate, Dinesh J. Telang, Brian J. Miles, Riad N. Farah, Ray H. Littleton, Aaron K. Kirkemo, James O. Peabody, David A. Burks, Caleb Fleming, Joseph C. Cerny Mar 1992

Radical Surgery In The Treatment Of Localized Carcinoma Of The Prostate, Dinesh J. Telang, Brian J. Miles, Riad N. Farah, Ray H. Littleton, Aaron K. Kirkemo, James O. Peabody, David A. Burks, Caleb Fleming, Joseph C. Cerny

Henry Ford Hospital Medical Journal

New methods of early detection combined with recent advances in surgical techniques have resulted in more patients undergoing radical surgery for treatment of localized carcinoma of the prostate. Over 350 radical prostatectomies have been performed by our group since January 1987. We review the role of radical prostatectomy in the treatment of prostate cancer and our experience with 100 patients undergoing radical retropubic prostatectomy since the advent of nerve-sparing techniques to preserve potency.


Management Of Impotence After Treatment Of Carcinoma Of The Prostate, Dinesh J. Telang, Riad N. Farah Mar 1992

Management Of Impotence After Treatment Of Carcinoma Of The Prostate, Dinesh J. Telang, Riad N. Farah

Henry Ford Hospital Medical Journal

Impotence commonly occurs as a result of treatment of carcinoma of the prostate. We review the etiology, evaluation, and treatment options available for these patients as well as our experience with fifty prostate cancer patients who underwent placement of penile prostheses. Several excellent alternatives are available for patients with impotence resulting from treatment of carcinoma of the prostate.


Maximal Androgen Ablation: A Review, Brian J. Miles, Joseph Babiarz Mar 1992

Maximal Androgen Ablation: A Review, Brian J. Miles, Joseph Babiarz

Henry Ford Hospital Medical Journal

Primary management of advanced (stage D) adenocarcinoma of the prostate is androgen ablation. Since this principle was discovered in the early 1940s, therapeutic alternatives and "progress" have centered around different ways to obtain castrate levels of androgens. The role of adrenal androgens in supporting prostate or prostatic cancer growth has been debated for decades and until recently was believed to be minimal. In the 1980s the concept of maximum androgen suppression, involving both the testes and adrenal glands, was reintroduced with some investigators claiming exceptional results. We review studies that have examined this concept, with emphasis on the largest trial ...


Advances In Therapy Of Female Stress Incontinence, Carl G. Klutke Mar 1992

Advances In Therapy Of Female Stress Incontinence, Carl G. Klutke

Henry Ford Hospital Medical Journal

No abstract provided.


Megakaryoblastic Termination Of Myeloproliferative Disorders, Mahul B. Amin, Koichi Maeda, John L. Carey, Ramesh V. Babu, B. K. S. Raman Mar 1992

Megakaryoblastic Termination Of Myeloproliferative Disorders, Mahul B. Amin, Koichi Maeda, John L. Carey, Ramesh V. Babu, B. K. S. Raman

Henry Ford Hospital Medical Journal

Megakaryoblastic termination of myeloproliferative disorders is rare. The morphology of megakaryoblastic transformation can be subtle and is often mistaken for myeloid or lymphoid proliferations. Previously reported observations suggest a relatively poor prognosis for this category of patients, making precise diagnosis imperative. A multifaceted approach using morphology, ultrastructure, cytochemistry, and immunological membrane analysis may be helpful. We present two cases of myeloproliferative disorder with aggressive megakaryoblastic phases (myelofibrosis with agnogenic myeloid metaplasia and chronic myeloid leukemia with blast crisis). The clinical course is described and the results of the morphological, cytochemical, ultrastructural, and cytogenetic studies of both cases are presented. In ...