Diagnostic and interventional neuroradiology training in the UK: a national trainee survey.

AIM: Training structure in neuroradiology can be variable, nationally and internationally. Globally, there is a trend towards standardised training pathways, curricula and targeted competencies. Currently, there is limited understanding of the structure of neuroradiology training in the UK. This survey aims to: [1] identify different contemporary models of neuroradiology training in the UK, [2] compare UK trainees' commitments against national and international standards, and [3] understand whether career expectations match the predicted future demands of neuroradiologists. MATERIALS AND METHODS: A survey was developed after consultation with BSNR and UKNG representatives. The eligibility criteria included current neuroradiology trainees in the UK with at least 3 months of experience or had recently completed neuroradiology training, but less than 18 months had elapsed since achieving a certificate of completion of training. RESULTS: A total of 50 trainees responded to the survey; 26 (52%) diagnostic neuroradiologists (DNRs) and 24 (48%) interventional neuroradiologists (INRs) with an overall mean age of 33 years. The mean duration of training at the time of survey was 18 months. The survey details trainee demographics, experience at work, research and teaching commitments and future goals. CONCLUSION: Most respondents are satisfied with their training and 90% want to remain in the UK after completion of training. There is room for improvement but the future of training and working in neuroradiology seems promising internationally, with ever-evolving techniques and developments. ADVANCES IN KNOWLEDGE: Advances in knowledge: This study evaluates neuroradiology training in the UK to enhance the training of future neuroradiologists, and safeguard the future of the speciality.

Reducing radiation exposure in neurointervention through dedicated training on the biplane angiographic system.

AIM: To investigate whether the radiation dose in neurointerventional procedures is reduced if the interventionalist has a better working knowledge and skill to operate the biplane angiographic system (BAS). MATERIALS AND METHODS: It is common practice in most centres in the UK for radiographers to drive many of the functions of the BAS under the instruction of the interventionalist who performs the procedure. The dose profile of a neurointerventionalist who was trained to perform procedures while operating the BAS independently was evaluated against that of a highly experienced neurointerventionalist when operating with a radiographer-assisted BAS. RESULTS: The dose-area product for 57 procedures was collected retrospectively. Working independently resulted in a statistically significant lower mean dose of 4,655 µGy·m2 compared to mean doses above 7,000 µGy·m2 with a radiographer-assisted BAS (p<0.05). Effectively this allowed for the mean dose to be reduced by as much as 38%. CONCLUSION: This study suggests that improved knowledge and skill in operating the BAS gives the neurointerventionalist the opportunity to minimise radiation dose. Therefore, this should be part of the skillset acquired by a qualified neurointerventionalist and be formally addressed in the interventional radiology curriculum.18.

Prediction of preterm birth.

Preterm delivery is birth occurring before 37 completed weeks of gestation. Preterm birth is the primary cause of morbidity and mortality in children especially if this occurs before 34 weeks of gestation. If preterm birth could be predicted and treated accordingly, this would greatly reduce mortality, morbidity and associated costs. There have been many attempts to develop an accurate and efficient method to predict preterm premature rupture of membranes (PPROM) and preterm labor that leads to spontaneous preterm birth (SPB). However, the initial signs and symptoms are most often mild and may even occur in normal pregnancies, making early detection rather difficult. The aim of this paper is to provide an overview of the current methods employed in predicting preterm birth occurring due to preterm labor and PPROM. Among these methods are risk scoring systems, cervical/vaginal screening for fetal fibronectin, cervical assessment by ultrasonography, uterine activity monitoring, biomarkers such as endocrine factors, cytokines and enzymes, fetal DNA and genetic polymorphism. SPB is multifactorial, and so it is highly unlikely that a single test can accurately predict SPB. A combination of biological markers is also reviewed in the estimation of the risk of preterm delivery.

A Prospective, Randomized, Double-Blind, Placebo-Controlled Clinical Trial Comparing the Efficacy of Anti-edema Drugs for Edema Control in Orthognathic Surgery Using Digitizer 3-D to Measure Facial Swelling.

INTRODUCTION: Orthognathic surgery involves making several osteotomies. Any osteotomies leads to varying degrees of post-operative swelling. The aim of this study was to evaluate the effectiveness of anti-edema drugs for the control of edema, using Digitizer 3D™ for measuring soft-tissue thickness, in patients who underwent bimaxillaryorthognathic surgery. MATERIALS AND METHODS: In this double-blinded, randomized, control trial, 24 patients (study group: 12 patients, control group: 12 patients) in whom bimaxillary orthognathic surgery was indicated, were included in this study. All swelling measurements were expressed as total 3-D area of the landmarks (cm(2)) in T0 pre-operative, T1 first day after surgery, T2 fourth day after surgery, T3 4 months after surgery. For each patient we compared, by adding left and right area, the increase of swelling between T1-T0, T2-T0 and T1-T3. RESULTS: The differences T0-T1 are highly significant (p < 0.01) between group 1 or study group (treated with Venoplant(®)) and group 2 (control group); the differences T0-T2 are significant (p < 0.05) between group 1 (treated with Venoplant(®)) and group 2 (control group). The differences T1-T3 are significant (p < 0.05) between group 1 (treated with Venoplant(®)) and group 2 (control group). DISCUSSION: The present study suggests that Venoplant(®) significantly decreases postoperative edema in orthognathic surgery, thus precluding long-term corticosteroid use.

[Bronchoalveolar lavage in lower respiratory tract infections in patients with bronchopulmonary carcinoma. Our experience]. / Il lavaggio broncoalveolare nelle infezioni delle basse vie respiratorie nei pazienti con carcinoma broncopolmonare. Una nostra esperienza.

UNLABELLED: In order to evaluate the usefulness of the endoscopic procedures with BAL, we conducted a study on 92 patients with diagnosis of lung cancer, underwent to chemotherapy, identifying pathogenic species involved and the antibiotic sensibility and antibiotic resistance. Moreover, to evaluate possible modifications of alveolar cell population in neutropenic patients, we studied the specimens from BALs performed via fibreoptic bronchoscopy. METHODS: The cellular pattern of BALs in terms of concentration of total cells, concentrations of alveolar macrophages (AMs), of polymorphonucleates (PMNs) and lymphocytes (Ls) were compared in neutropenic and non-neutropenic patients. RESULTS: In the statistical analysis of our study we found a correlation, statistically significant, between patients with neutropenic episodes on the previous chemotherapy courses and incidence of LTRI. The mean concentrations x 100,000/ml of BAL fluid of total alveolar cells, AMs, PMNs and Ls were significantly lower, after chemotherapy, in group of neutropenic patients than in non neutropenic patients, respectively. CONCLUSIONS: In this study we found that during neutropenia the alveolar cell population was quantitatively deficient, confirming the hypothesis, proposed by other authors, of "lung aplasia" as a consequence or a concomitant event of chemotherapy-induced marrow toxicity.