Latest news – Page 2751
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Anatomy of a hernia
A hernia is a rupture or tear in a piece of tissue (usually muscle) inside the body which allows some underlying structure to protrude through the hole. Common sites include where the oesophagus passes through the diaphragm (hiatus hernia); the belly button (umbilical hernia); and the groin (inguinal and femoral ...
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The operation
Hernia can be repaired under general or local anaesthetic but, in its 1993 guidelines, the RCS advised against local anaesthesia in obese, anxious or unco-operative patients. Inguinal hernias can be repaired in several different ways but the three main methods are:
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What can go wrong?
Wound complications, post-operative pain and recurrence are the main problems associated with groin hernia repair. As with other laparoscopic surgery, there have been reports of major internal damage associated with keyhole hernia operations (eg: perforated intestine, haemorrhage and nerve damage).
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Chief causes of wasteful radiology - and six questions doctors should ask
Investigation when results are unlikely to affect patient management because the result is usually irrelevant. For example, degenerative spinal disease is as normal as grey hairs in middle age.
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Sound advice: ultrasound checks for pregnant women
One or more ultrsound checks are now routine in pregnancy. The Royal College of Radiologists guidelines say these are useful because they provide information about the expected date of delivery and multiple pregnancies, but they admit the scientific basis remains controversial.2
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Monitor
Monitor is delighted to bring news, not so much from the cutting edge as the ready-sliced front line of hospital catering: NHS Supplies has signed the 'first ever national contract for prepared sandwiches'. The health service spends £8m to £10m a year on its bagels, baps and bread rolls, and ...
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Unfortunate Manor
Manor House Hospital's close union links allowed it to stay independent when the NHS was formed. Now it may close. Barbara Millar reports
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The workers' friend
Manor House Healthcare can trace its roots back to September 1914, when a hospital was established in northern France to care for soldiers injured in the First World War.
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Milburn will rush in if Denham fears to tread
Long-awaited PFI guidance leaves knotty problems unresolved
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Loot is not the only route
'There is a risk that the case for pay increases will be accepted uncritically. What is needed is better management of human resources'
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WEB WATCH
When New York University chemistry professor Nadrian Seeman announced earlier this month that he had come up with a way to make a 'gene machine' out of DNA, his discovery conjured up images from the film Fantastic Voyage in which a miniaturised submarine was injected into a human body.
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Trying to stay calm in the face of an ill-informed attack on my profession
Public health specialists
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Three classic errors which serve to betray Ainsworth's ignorance
Steve Ainsworth questions the worth of public health physicians and offers us up to fill the growing gap of GPs. He makes three classic errors.
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Continuing role for us in the modernised NHS
I reject Steve Ainsworth's suggestion that there will be no role for public health doctors in the new NHS.
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Cancer and heart disease are preventable - and both are amenable to public health action
Cancer and heart disease are indeed diseases of old age, as Steve Ainsworth suggests, but he seems unaware they are both preventable and amenable to public health action. Such action is ultimately about political change outwith healthcare systems.
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Scary inaccuracy
In his frighteningly inaccurate portrayal of public health doctors, Steve Ainsworth refers to 'large numbers of full-time medics... so beloved by health authorities'. Authorities with that view no longer exist, if they ever did. Many have few, but very hard working, public health physicians providing effective medical and public health ...
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Keep your distance
Why do so many NHS staff address adult patients by their first names? Many patients do not like it, particularly elderly ones, and especially their relatives. It may be well-meaning to ask patients on admission to hospital, 'What do your friends call you?' or 'What do you like to be ...