How young radiologists use contrast media and manage adverse reactions: an international survey.

OBJECTIVES: To collect real-world data about the knowledge and self-perception of young radiologists concerning the use of contrast media (CM) and the management of adverse drug reactions (ADR). METHODS: A survey (29 questions) was distributed to residents and board-certified radiologists younger than 40 years to investigate the current international situation in young radiology community regarding CM and ADRs. Descriptive statistics analysis was performed. RESULTS: Out of 454 respondents from 48 countries (mean age: 31.7 ± 4 years, range 25-39), 271 (59.7%) were radiology residents and 183 (40.3%) were board-certified radiologists. The majority (349, 76.5%) felt they were adequately informed regarding the use of CM. However, only 141 (31.1%) received specific training on the use of CM and 82 (18.1%) about management ADR during their residency. Although 266 (58.6%) knew safety protocols for handling ADR, 69.6% (316) lacked confidence in their ability to manage CM-induced ADRs and 95.8% (435) expressed a desire to enhance their understanding of CM use and handling of CM-induced ADRs. Nearly 300 respondents (297; 65.4%) were aware of the benefits of contrast-enhanced ultrasound, but 249 (54.8%) of participants did not perform it. The preferred CM injection strategy in CT parenchymal examination and CT angiography examination was based on patient's lean body weight in 318 (70.0%) and 160 (35.2%), a predeterminate fixed amount in 79 (17.4%) and 116 (25.6%), iodine delivery rate in 26 (5.7%) and 122 (26.9%), and scan time in 31 (6.8%) and 56 (12.3%), respectively. CONCLUSION: Training in CM use and management ADR should be implemented in the training of radiology residents. CRITICAL RELEVANCE STATEMENT: We highlight the need for improvement in the education of young radiologists regarding contrast media; more attention from residency programs and scientific societies should be focused on training about contrast media use and the management of adverse drug reactions. KEY POINTS: • This survey investigated training of young radiologists about use of contrast media and management adverse reactions. • Most young radiologists claimed they did not receive dedicated training. • An extreme heterogeneity of responses was observed about contrast media indications/contraindications and injection strategy.

Encenação do decálogo da saúde mental positiva: relato de experiência num internamento de psiquiatria de agudos / Acting out of the positive mental health decalogue: an experience report in an acute psychiatric hospitalization / Escenario de lo decalogo de salud mental positiva: informe de experiencia en una hospitalización de psiquiatría aguda

Resumo Contexto: A prevalência de perturbações psiquiátricas justifica um maior investimento na promoção da Saúde Mental, ainda que conscientes de que esta prioridade se mantém um desafio nas políticas de saúde. A promoção do bem-estar da pessoa com perturbação mental com recurso a intervenções psicoterapêuticas, implementadas pelo enfermeiro especialista em Saúde Mental, constituiu-se um desafio nesta experiência. Objetivo(s): Descrever um relato de experiência decorrente de um programa de Saúde Mental Positiva desenvolvido num serviço de internamento de agudos. Métodos: Trata-se de um programa que se concretiza na encenação do Decálogo de Saúde Mental Positiva da autoria de Lluch-Canut (2011). Utilizou-se uma metodologia participativa envolvendo os utentes com doença mental (n=24), destacando-se a Depressão Major, a Esquizofrenia e a Doença Bipolar. Participaram, ainda, enfermeiros especialistas em Saúde Mental e Psiquiatria e estudantes de Enfermagem desde a conceção do guião, planeamento, preparação do cenário e dramatização. Resultados: Os resultados da avaliação deste programa revelaram i) elevada adesão dos utentes internados; ii) que o programa constituiu uma experiência significativa para os utentes; iii) que o programa foi um contributo para o alcance de fatores promotores de Saúde Mental Positiva, integrantes do Modelo Multifatorial apresentado por Lluch-Canut (1999): satisfação pessoal; atitude pro-social; autocontrolo; autonomia; resolução de problemas e auto-atualização e habilidades de relacionamento interpessoais. Conclusões: A encenação, com a participação ativa dos utentes internados e profissionais de saúde, foi eficaz na expressão de emoções positivas, nos envolvidos, pelo que se sugere um maior investimento neste tipo de intervenções em pessoas com doença mental.

Abstract Background: The prevalence of psychiatric disorders justifies an investment in the promotion of Mental Health, although aware that this priority remains a challenge in health policies. The promotion of the well-being of the person with mental disorders, recurring to psychotherapeutic interventions, implemented by the specialist nurse in Mental Health, was also a challenge in this experience. Aim: To describe an experience report resulting from a Positive Mental Health Program developed in an acute hospitalization service. Methods: The experience made use of the Decalogue of Positive Mental Health by Lluch-Canut (2011). A participatory methodology involving people with mental illness (n=24) was used, highlighting Major Depression, Schizophrenia and Bipolar Disorder. Also participating were nurses specialized in Mental Health and Psychiatry and Nursing students from the conception of the script, planning, scenario preparation and dramatization. Results: The results of the evaluation of this program revealed i) high support of hospitalized users; (ii) that the program was a significant experience for users; iii) the intervention program contributed to achieving promoting factors of Positive Mental Health, integrated on the multifactorial model presented by Lluch-Canut (1999) such as: personal satisfaction; pro-social attitude; self-control; autonomy; problem-solving and self-updating; and interpersonal skills. Conclusions: The dramatization, with the active participation of hospitalized users and health professionals, was effective in expressing positive emotions of all people involved, suggesting a greater investment in this type of intervention in people with mental illness.

Resumen Contexto: La prevalencia de los trastornos psiquiátricos, justifica una mayor inversión en la promoción de la Salud Mental, aún sabiendo que esta prioridad se mantiene como un desafío en las políticas de salud. En este sentido, la promoción del bienestar de la persona con trastorno mental con el uso de intervenciones psicosociales, implementado por la enfermera especialista en Salud Mental, también fue un desafío en esta experiencia. Objetivo(s): Describa un informe de experiencia resultante de un Programa de Salud Mental Positiva con actividades desarrolladas en un servicio de hospitalización de internación aguda. Metodología: Se trata de una experiencia en la que dio lugar a la realización de la puesta en escena del Decálogo de Salud Mental Positiva por Lluch-Canut (2011). Se utilizó una metodología participativa en la que participaron usuarios hospitalizados con enfermedad mental (n=24), de los cuales hemos resaltamos de la Depresión Mayor, Esquizofrenia y Trastorno Bipolar. La implementación del programa de intervención contó con la participación de enfermeros especializados en Salud Mental y Psiquiatría y estudiantes de Enfermería desde el diseño del guión, planificación, preparación de escenarios y dramatización. Resultados: Los resultados de la evaluación de este programa revelaron i) un alto adhesión de los usuarios hospitalizados; (ii) que el programa fue una experiencia muy significativa para los usuarios; iii) que el programa de intervención fue una contribución al logro de factores que promueven la Salud Mental Positiva, miembros del Modelo Multifactorial presentado por Lluch-Canut (1999), a saber: satisfacción personal; actitud pro-social; autocontrol; autonomía; resolución de problemas y autoactualización y habilidades de relación interpersonal. Conclusiones: La puesta en escena, con la participación de usuarios hospitalizados y profesionales de la salud, fue eficaz para expresar emociones positivas de todas las personas involucradas, sugiriendo una mayor inversión en este tipo de intervenciones en personas con enfermedades mentales.

Sporadic inclusion body myositis: a rare hazardous entity with important imaging findings.

Inclusion body myositis is a rare acquired muscle disease that predominantly affects individuals older than 45 years of age and that has been classified as an idiopathic inflammatory myopathy. However, it has a distinct course being characterized by a slowly progressive weakness and resistance to immunosuppressive therapy. This diagnosis is usually based on a typical clinical presentation, elevated serum skeletal muscle enzymes, electromyographic findings and muscle biopsy. Magnetic Resonance Imaging (MRI) can aid in the diagnosis by directing muscle biopsy sites through accurate localization of muscle involvement, which avoids the high false-negative rate of blind muscle biopsies. MRI can also depict the nature and extent of muscle abnormalities with high signal intensity seen in the active phase and refractory treated patients on fluid-sensitive images. Recently, there has been important progress in the understanding of IBM. These advances may lead to improved diagnosis and the discovery of effective drug treatments for this debilitating entity with usually poor prognosis and high levels of disability.