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Consultative Services.
The main consultative functions of the Chest Clinic have continued as in previous
years. The volume of work has been maintained. There is a slight decline in
total attendances due principally to a diminution in the numbers of patients for
refill treatment. Collapse measures are less frequently used in the treatment of
tuberculosis than formerly as long term chemotherapy is taking the lead as a favourite
method of control.
Most of the patients seen are referred by their practitioners and considerable
use is made of the system of "Chest X-Ray Only" for which no prior appointment is
necessary.
B. C. G. Vaccination.
The Clinic staff have continued to undertake B.C.G. vaccination of suitable
members of the staff of the Group and those needing it amongst domiciliary contacts
of our tuberculous patients.
Tuberculosis.
The total number on the Tuberculosis Register decreased slightly. It will, it
is hoped, show a further decrease in future years. There has been a big decrease in
deaths, but the 1956 figure is not typical and is a bad comparison for 1957, for in
the early months of 1956 an extra number of deaths occurred during exceptionally
cold weather. So the improvement is not so great as might appear at first sight.
Domiciliary treatment - particularly using chemotherapeutic drugs - has been
continued on a considerable scale. This has shortened the time necessary for inpatient
treatment and ensured that the waiting list has remained small.
Antenatal Patients.
There are reasons for believing that abdominal X-rays of pregnant women should
be avoided unless essential. Chest X-rays are in a different category and the Odelca
is specially coned to prevent exposure of the abdomen. So it is safe for pregnant
women . For some years a scheme operated by Edgware and Harrow Chest Clinics has given
facilities for chest X-ray for pregnant women. The Edgware results are detailed in
the accompanying table and give an incidence of 1.3 cases of active tuberculosis per
1000 X-rayed, which is about the same rate as is found for women by Mass X-Ray Units
operating in the vicinity.
It has been estimated that in Hendon the percentage of women aged 15 to 44 who
may be expected to be pregnant at any one time is 4.7. The percentage for the Borough
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