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Background: National guidelines in England recommend prompt chest X-ray (within 14 days) in patients presenting in general practice with unexplained symptoms of possible lung cancer, including persistent cough, shortness of breath, or weight loss.Aim: To examine time to chest X-ray in symptomatic patients in English general practice before lung cancer diagnosis, and explore demographical variation.Design and Setting: Retrospective cohort study using routinely collected general practice, cancer registry, and imaging data from England.Method: Patients with lung cancer who presented symptomatically in general practice in the year pre-diagnosis and who had a pre-diagnostic chest X-ray were included. Time from presentation to chest X-ray (presentation-test interval) was determined and intervals classified based on national guideline recommendations as concordant (≤14 days) or non-concordant (>14 days). Variation in intervals was examined by age, sex, smoking status, and deprivation.Results: In a cohort of 2102 patients with lung cancer, the median presentation-test interval was 49 (interquartile range [IQR] 5-172) days. Of these, 727 (35%) patients had presentation-test intervals of ≤14 days (median 1 [IQR 0-6] day) and 1375 (65%) had presentation-test intervals of >14 days (median 128 [IQR 52-231] days). Intervals were longer among patients who smoke (equivalent to 63% longer than non-smokers; P<0.001), older patients (equivalent to 7% longer for every 10 years from age 27; P = 0.013), and females (equivalent to 12% longer than males; P = 0.016).Conclusion: In symptomatic primary care patients who underwent chest X-ray before lung cancer diagnosis, only 35% were tested within the timeframe recommended by national guidelines. Patients who smoke, older patients, and females experienced longer intervals. These findings could help guide initiatives aimed at improving timely lung cancer diagnosis. [ABSTRACT FROM AUTHOR]

Introduction: The United Kingdom (UK) government's healthcare policy in the early 1990s paved the way adoption of the skills mix development and implementation of diagnostic radiographers' X-ray reporting service. Current clinical practice within the public UK healthcare system reflects the same pressures of increased demand in patient imaging and limited capacity of the reporting workforce (radiographers and radiologists) as in the 1990s. This study aimed to identify, define and assess the longitudinal macro, meso, and micro barriers and enablers to the implementation of the diagnostic radiographer musculoskeletal X-ray reporting service in the National Healthcare System (NHS) in England., Methods: Multiple independent databases were searched, including PubMed, Ovid MEDLINE; Embase; CINAHL, and Google Scholar, as well as journal databases (Scopus, Wiley), healthcare databases (NHS Evidence Database; Cochrane Library) and grey literature databases (OpenGrey, GreyNet International, and the British Library EthOS depository) and recorded in a PRISMA flow chart. A combination of keywords, Boolean logic, truncation, parentheses and wildcards with inclusion/exclusion criteria and a time frame of 1995-2022 was applied. The literature was assessed against Joanna Briggs Institute's critical appraisal checklists. With meta-aggregation to synthesize each paper, and coded using NVivo, with context grouped into macro, meso, and micro-level sources and categorised into subgroups of enablers and barriers., Results: The wide and diverse range of data (n = 241 papers) identified barriers and enablers of implementation, which were categorised into measures of macro, meso, and micro levels, and thematic categories of context, culture, environment, and leadership., Conclusion: The literature since 1995 has reframed the debates on implementation of the radiographer reporting role and has been instrumental in shaping clinical practice. There has been clear influence upon both meso (professional body) and macro-level (governmental/health service) policies and guidance, that have shaped change at micro-level NHS Trust organisations. There is evidence of a shift in culturally intrenched legacy perspectives within and between different meso-level professional bodies around skills mix acceptance and role boundaries. This has helped shape capacity building of the reporting workforce. All of which have contributed to conceptual understandings of the skills mix workforce within modern radiology services., (© 2023. The Author(s).)

Objectives: The aim of this study was to close ventricular septal defects (VSDs) directly through the chest wall using magnetic resonance imaging (MRI) guidance, without cardiopulmonary bypass, sternotomy, or radiation exposure. Background: Surgical, percutaneous, and hybrid management of VSD each have limitations and known morbidity. Methods: Percutaneous muscular VSDs were created in 10 naive Yorkshire swine using a transjugular laser catheter. Under real-time MRI guidance, a direct transthoracic vascular access sheath was introduced through the chest into the heart along a trajectory suitable for VSD access and closure. Through this transthoracic sheath, muscular VSDs were occluded using a commercial nitinol device. Finally, the right ventricular free wall was closed using a commercial collagen plug intended for arterial closure. Results: Anterior, posterior, and mid-muscular VSDs (6.8 ± 1.8 mm) were created. VSDs were closed successfully in all animals. The transthoracic access sheath was displaced in 2, both fatal. Thereafter, we tested an intracameral retention sheath to prevent this complication. Right ventricular access ports were closed successfully in all, and after as many as 30 days, healed successfully. Conclusions: Real-time MRI guidance allowed closed-chest transthoracic perventricular muscular VSD closure in a clinically meaningful animal model. Once applied to patients, this approach may avoid traditional surgical, percutaneous, or open-chest transcatheter (“hybrid”) risks. [ABSTRACT FROM AUTHOR]

The article discusses the possibilities that are suggested by the advent of the X-ray technology discovered by Wilhelm Conrad Röntgen in late-Victorian England. It says that the association of the X-ray with photography complicated the technology's status as an instrument of visual information. It also states that the photographic medium can be understood in the context of nineteenth-century by considering what it means to a contemporary audience and the way they complicated the definitions of objectivity, truth and document.

The article discusses developments in the orthopedic medicine in London, England. In 1895, the X-ray was discovered by Wilhem Conrad Röntgen. Robert Jones is considered as the father of British orthopedic surgery. The orthopedic application of tomography was started after World War II. Alexander Fleming produced the first antibiotic penicillin in 1943. It is stated that the investigation of spinal lesions is the greatest collaboration between radiologists and orthopedic surgeons.

Examines the reasons of requesting x-ray examinations for acute ankle injuries in London, England. Revision on the notes and radiographs of patients with ankle injuries; Assessment on the number of radiographs of the foot requested by patients; Conclusion that the absence of clinical tissue swelling indicates that no ligamentous damage is present.

Discusses the future of Daresbury Laboratory in England as of October, 2000. Laboratory's attainment of government funding for nine collaborative projects; How Daresbury houses Great Britain's only synchrotron light source, which create X-rays to determine the structure of biological molecules; Description of the projects, including a Third Generation Proteomics project with the University of Manchester Institute of Science and Technology.

The article cites a study which reports that diagnostic likelihood of exposing the testes to radiation and are taken within one year before men father a child may have detrimental effects on the infant. Among 7,678 infants born in 1991-1992 in Avon, England, 172 had fathers who had undergone an X ray of the abdominal or pelvic area in the year before conception. The study found that these infants weighed, on average, 79 grams less at birth than those whose fathers had not had such a test. It suggest an association between men's exposure to X-rays and effects on reproductive out-comes.

Background: Most lung cancers present symptomatically, but the pathway to diagnosis in primary care can be complex and is poorly understood. Significant event audit (SEA) is a quality improvement technique widely used in UK general practice., Aim: To gain insights into the diagnostic process for lung cancer, drawn from analysis of SEA documents., Design and Setting: Qualitative analysis of SEAs from 92 general practices in the North of England Cancer Network., Method: Participating practices were provided with a standardised electronic template and asked to undertake a significant event audit related to the most recent diagnosis of lung cancer in the practice, even if that patient had since died. Reported accounts for 132 diagnoses were analysed using a modified framework approach., Results: Most SEAs demonstrated timely recognition and referral. Where this had taken longer, there were often reasonable explanations, including: chest X-rays reported as normal or with benign findings; patient-mediated factors, such as delay in re-presenting or declining earlier referral; and presentation complicated by comorbidity. Some opportunities for earlier referral were also found. Lessons drawn from these events included limitations of chest X-ray as a diagnostic tool, the need for vigilance in patients with existing morbidity, and the importance of 'safety-netting'., Conclusion: Qualitative synthesis of SEAs offered considerable value in understanding circumstances surrounding the diagnostic process for lung cancer in primary care. The most common presentation was with cough or other symptoms indicative of infection, and it is by understanding more about these patients in particular that most can be gained.