Research amongst Irish surgical trainees: what's the trend?

INTRODUCTION: A high publication rate for surgical trainees is considered a prerequisite for progression to Higher Specialist Training (HST). This rate has arguably been decreased by the formation of a new 'run-through' training pathway. We aim to quantify the number of publications that the 'new' pathway trainees have attained compared to the 'old' pathway trainees. We further aim to compare the H-index and average citations between General Surgery (GS) and Trauma and Orthopaedic (T&O) trainees. METHODS: Publications from old pathway trainee years 2007-2014 (T&O n = 59, GS n = 64) were compared with new pathway trainees from 2015 to 2016 (T&O n = 11, GS n = 12). H-index and average citations were also compared for trainees commencing HST years 2007-2009. Statistical analysis involved D'Agostino normality testing. An unpaired Student's t test ± Welch's correction was utilised for parametric data and a Mann-Whitney U test for non-parametric data. RESULTS: The average number of publications attained by the old pathway T&O trainee was 4.2 ± 3.1 and was 3.1 ± 2.4 for the new trainee. Old GS trainees had an average of 6.5 ± 3.3 publications prior to HST with new GS trainees having an average of 3.7 ± 2.8 publications. The average H-index attained for GS trainees on completion of the HST pathway was 5.1 ± 3.2 and 4.6 ± 2.4 for T&O trainees. CONCLUSION: There has been a significant decrease in publication rates between new and old GS pathways. No significant changes were identified between new and old T&O pathways. There was no difference between H-index and average citations between specialties.

Human immunodeficiency virus type 1 protease inhibitors.

Until recently, treatment for human immunodeficiency virus type 1 (HIV-1) infection was limited to the use of nucleoside inhibitors of the viral enzyme reverse transcriptase. While these agents initially offered promise, they have only modest antiviral activity and the benefits of treatment are limited by the emergence of drug resistance and dose-limiting toxic effects. Development of more potent drugs that target different stages of the virus life cycle has thus been aggressively pursued. Efforts to develop inhibitors of HIV-1 protease have yielded a potent new class of compounds that suppress HIV-1 replication to an extent far greater than was previously attainable. Four protease inhibitors, saquinavir mesylate, ritonavir, nelfinavir, and indinavir sulfate, have been approved by the Food and Drug Administration. Other agents are undergoing active investigation. The purpose of this article is to review the currently available data on those agents that have been approved for clinical use.

Case report: neutrophilic CSF pleocytosis in hypertensive encephalopathy.

A patient with hypertensive crisis developed encephalopathy with a lumbar puncture revealing neutrophilic pleocytosis. No explanation for her case could be found, eg, no evidence of infection or vasculitis. It is concluded that the most probable cause of her neutrophilic cerebrospinal fluid pleocytosis is hypertensive encephalopathy.

Subdural empyema: analysis of 32 cases and review.

Thirty-two patients with subdural empyema at the University Hospital (Birmingham, AL) during the period from June 1970 through June 1992 were identified retrospectively. Clinical presentations of patients, methods of diagnosis, results of microbiological tests, types of therapy used, and outcomes of patients are presented and compared with those found in prior reports. The patients were separated into three groups based on the etiology of their disease: sinusitis, trauma and/or neurosurgery, and other miscellaneous causes. Sinusitis accounted for 56% of the cases; the predominant organisms isolated from these patients were anaerobes and streptococci. No cases occurred secondary to otitis media. The overall mortality rate was 9%; however, 55% of patients had neurological deficiency at the time they were discharged from the hospital. Factors that affected survival were age (P < .007) and level of consciousness at presentation (P < .008).

The effect of structure in a long target RNA on ribozyme cleavage efficiency.

Inhibition of gene expression by catalytic RNA (ribozymes) requires that ribozymes efficiently cleave specific sites within large target RNAs. However, the cleavage of long target RNAs by ribozymes is much less efficient than cleavage of short oligonucleotide substrates because of higher order structure in the long target RNA. To further study the effects of long target RNA structure on ribozyme cleavage efficiency, we determined the accessibility of seven hammerhead ribozyme cleavage sites in a target RNA that contained human immunodeficiency virus type 1 (HIV-1) vif - vpr . The base pairing-availability of individual nucleotides at each cleavage site was then assessed by chemical modification mapping. The ability of hammerhead ribozymes to cleave the long target RNA was most strongly correlated with the availability of nucleotides near the cleavage site for base pairing with the ribozyme. Moreover, the accessibility of the seven hammerhead ribozyme cleavage sites in the long target RNA varied by up to 400-fold but was directly determined by the availability of cleavage sites for base pairing with the ribozyme. It is therefore unlikely that steric interference affected hammerhead ribozyme cleavage. Chemical modification mapping of cleavage site structure may therefore provide a means to identify efficient hammerhead ribozyme cleavage sites in long target RNAs.