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Gammathalamotomy in intractable pain (1980)

Steiner, L. ; Forster, D. ; Leksell, L. ; [et al.]

Springer

Acta neurochirurgica 52 (1980), S. 173-184

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ISSN: 0942-0940

Keywords: Pain ; thalamotomy ; radiosurgery

Source: Springer Online Journal Archives 1860-2000

Topics: Medicine

Notes: Summary Thalamotomy aiming at the CM-Pf complex and using stereotactic gamma irradiation has been performed in a series of 52 patients with severe pain due to malignancy. Lesions were produced either contra- or ipsilaterally to the side of the pain as well as bilaterally. Eight patients experienced good pain relief, 18 had moderate relief, and in 24 the operation did not significantly influence the pain. A second operation following recurrence of pain was rarely of value. There was a tendency towards more efficient relief of pain located in the face or in the arm and shoulder than of pain in the lower part of the body. Although contralateral lesions seem to be most effective, ipsilateral operations may also give some relief. The best results were obtained when the lesions were placed close to the wall of the third ventricle and at the level of the posterior commissure. Postmortem examination of 21 brains disclosed that the mean error in the placing of the lesions was about 1 mm. It is concluded that medial thalamotomy may be tried as a last resort in the treatment of cancer pain in selected patients with a short life expectancy.

Type of Medium: Electronic Resource

URL: http://dx.doi.org/10.1007/BF01402072

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Hospital Performance and Regional Equity (1984)

Forster, D. P. ; Frost, C. E. B.

Oxford, UK : Blackwell Publishing Ltd

Social policy and administration 18 (1984), S. 0

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ISSN: 1467-9515

Source: Blackwell Publishing Journal Backfiles 1879-2005

Topics: Political Science , Sociology

Notes: The objective of this article is to see whether or not the attainment of regional equity within the hospital sector has involved any sacrifice in hospital performance.1 For most health services providing medical care free of charge, regional equity is usually an important objective; but when doctors decide who gets into hospital and for how long regional equity may be difficult to achieve in practice. We look at certain indicators of hospital inpatient performance in relation to regional equity within the hospital sector in both England and Wales and Czechoslovakia. The comparison with Czechoslovakia is an interesting one because that country is as much concerned with regional equity in its hospital service as is the United Kingdom (UK). At the same time there have been substantial differences between the two countries in the availability of hospital resources.