Safety of Buscopan (it's safe)

Buscopan (hyoscine-N-butylbromide) is widely used as a spasmolytic for barium enemas, CT colonography, and abdominal MRI to improve the quality of the examination. It's a safe drug: safer than many people realise. Here is some sensible advice from the authors of a recent review article

All radiologists and radiographers either supervising examinations where this drug is used or those administering it directly to the patient need to be aware of the true contraindications. This should not include all patients with ischaemic heart disease or those with glaucoma. We would recommend that only patients with unstable cardiac disease have Buscopan withheld and that all patients are told to attend hospital immediately if, following the examination, they develop painful, blurred vision, in one or both eyes.

R. Dyde, A.H. Chapman, R. Gale, A. Mackintosh and D.J.M. Tolan
Precautions to be taken by radiologists and radiographers when prescribing hyoscine-N-butylbromide
Clinical Radiology 2008 July; 63 (7): 739-743.
doi:10.1016/j.crad.2008.02.008

Pubmed

Most radiologists feel that Buscopan is more effective than glucagon, and there are studies to support this view, such as this one by Rogalla et al (Radiology 2005;236:184-188).

I really can't figure out why it's not licensed in the United States. In the US it is approved for the treatment of flatulent colic in horses although not if the horses are going to be eaten by humans. (Link to product info)

The Radiology Assistant

the Radiology Assistant is the educational web site of the Radiological Society of The Netherlands, focusing on common radiological issues in a problem oriented way for radiology residents and radiologists.

This is an excellent site and a superb source of reference, with lots of succinct articles written by experts in the field. Highly recommended. Check it out. It's been added as a link in the sidebar of this blog.

"A centrally funded health service, free at the point of delivery"

This public information film from 1948, when the British National Health Service was founded, is a timely reminder of what it's all about.

...the hunt for a better funding model is never called off, with each new foray unfolding along similar lines. It begins with the NHS being judged as seriously underperforming. The real reason for this, whether admitted by the government of the day or not, is because not enough money is being spent on it. Early in the hunt comes sightings of the "bottomless pit" of insatiable healthcare demands, quickly followed by assertions that substantial increases in healthcare spending are "unsustainable." When asked for their advice, economists tell politicians that a tax based system provides governments and patients with the best deal. As a sideshow to the main event are the hucksters, peddling their own funding models, hoping that some of the billions spent on the NHS might end up in their pockets, or those of their backers.

Tony Delamothe, BMJ 2008;336:1410-1412 (21 June), doi:10.1136/bmj.a292
Free full text

Here is an excerpt from Michael Moore's Sicko (2007).

"Why does a CT scan cost so much in the USA?"

There's a post in Vijay's blog from October 2007 discussing the cost of healthcare in the United States http://www.catscanman.net/blog/?p=267. It makes interesting reading, as do the comments that have been posted by various people describing their experiences.

Here is the video about the incident:



There has been a lot of grumbling in Britain about the "Stalinist" National Health Service (NHS), but there are worse ways to organise a country's healthcare. I work for the NHS, and I am only too aware of its deficiencies, but those who wish to dismantle it should consider the possible consequences of alternative systems. Privatisation of the previously state-owned British railways did not lead to improved service. There is no inherent reason why a privatised national healthcare system in the UK will fare any better. Railway journeys in the UK are extremely expensive compared to the rest of the UK. I'm always being told how cheap it is to go shopping in the US compared to the UK. What will happen if our healthcare is privatised?

Link: Keep our NHS public

Radiology party trick

"What's wrong?"
"Someone stepped on me during the last dance."
"Want me to have a look at it?"
"OH MY GOD!!"

Read on.....

I've added the Samurai Radiologist's blog Not Totally Rad to my list. His posts cover all sorts of things other than radiology. There are imaging-related article as well, of course, including this one which reviews studies from the published literature, but may nevertheless be inaccessible from hospital PCs due to "adult content": Radiology comes through for sexual imaging.

My thanks to Vijay, : I found this indirectly via his blog.